Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Louisiana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Louisiana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Louisiana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Affinity Health Group, LLC (NPI 1023291226)

Key Findings

Field	Value
Entity Type	Organization
Organization	Affinity Health Group, LLC
Address	112 Saint John St
City	Monroe
State	LA
ZIP	71201
Taxonomy	Family Medicine Physician
NPI Enumerated	December 11, 2007

Payer Source	Total Paid
Medicaid	$34.6M
Medicare	$0

This provider is effectively single-payer in the available claims data: there is no Medicare billing on file while Medicaid lifetime revenue totals $34.6M, meaning Medicaid accounts for the entirety of reported program revenue. Analysts should treat Medicare-level comparisons as not applicable for this entity and focus on Medicaid performance and exposure.

Revenue is highly concentrated in a small set of office visit E/M codes: the precomputed top 3 Medicaid codes account for 68.0% of this provider's total Medicaid revenue, driven by 99214 ($10.9M revenue, 143.3K claims, 33.0% of Medicaid revenue), 99213 ($9.8M revenue, 169.4K claims, 29.8% of Medicaid revenue), and 99204 ($1.7M revenue, 14.6K claims, 5.2% of Medicaid revenue). This concentration shows that ambulatory evaluation-and-management visits are the dominant revenue stream.

The code mix and volumes are consistent with a high-throughput family medicine/primary care practice that delivers both adult and pediatric preventive care: high volumes for office visits 99214 and 99213 are complemented by preventive visit codes 99392, 99391, 99393, 99395 and 99396, and large vaccination activity (90471, 90472). These patterns point to a full-service outpatient practice model that pairs routine E/M visits with well-visits and immunizations across age groups.

Statewide competitive standing on the top E/M codes is exceptionally strong: 99214 ranks #12 of 2894 providers in-state at the 100th percentile and is labeled an "extreme outlier, far above typical state volume for this code," while 99213 ranks #18 of 3226 providers at the 99th percentile ("extreme outlier"). 99204 also ranks highly (#20 of 1172, 98th percentile, "notably above typical state volume"), indicating this provider is a dominant Medicaid outpatient E/M presence in Louisiana for these service lines.

Operational throughput signals are apparent from claim counts across multiple service lines: 99214 has 143.3K claims and 99213 has 169.4K claims, while immunization administration shows 41.6K claims for 90471 and 24.3K for 90472. High counts for routine lab and point-of-care testing (e.g., 87635 at 30.4K claims, 87502 at 20.4K claims, 85025 at 44.9K claims) further indicate an integrated clinic workflow that performs large volumes of visits, vaccinations, and basic diagnostics onsite.

Beyond office visits, the provider captures meaningful ancillary revenue from diagnostic testing and vaccine-related services: notable entries include 87635 ($1M revenue, 30.4K claims) and 87502 ($1.3M revenue, 20.4K claims) for infectious disease testing, plus laboratory panel and vitamin D testing such as 80050 and 82306. These ancillary lines are ranked highly in-state (many in the 90th+ percentiles) and suggest the practice maintains testing capacity that supplements its E/M-driven revenue base.

The payer concentration and code-weighted business mix imply policy sensitivity: with $34.6M entirely from Medicaid and 68.0% of that Medicaid revenue concentrated in three E/M codes, changes to Medicaid E/M reimbursement, prior-authorization rules, or visit policies would disproportionately affect this provider's revenue. Contracting teams and risk-modelers should treat changes to outpatient E/M rates as a primary financial lever for this entity.

This NPI has long-standing presence in the market, enumerated on 2007-12-11 (~19 years ago), which supports interpretation of the high volumes as an established operational footprint rather than a short-term spike. Longevity combined with extreme statewide ranks on core E/M codes suggests a durable, high-volume Medicaid primary care operation rather than a transient billing pattern.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

223 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	143,250	$80	$10.9M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	169,430	$60	$9.8M
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	14,560	$120	$1.7M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	20,450	$60	$1.3M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,310	$70	$1.2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,820	$60	$1.1M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	30,370	$30	$1M
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	10,450	$90	$909.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	41,650	$10	$583K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,170	$70	$480.4K

Showing 1–10 of 223

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Louisiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Louisiana Distribution

Affinity Health Group, LLC — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

223 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	12	2,890	980	$40	$246.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	9	210	630	$70	$239.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	262	330	1,390	$40	$236.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	28	190	660	$70	$234.9K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	187	410	1,990	$40	$231.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	178	370	1,080	$40	$212.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	18	3,230	1,120	$30	$204.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	238	470	560	$40	$157.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12	360	780	$50	$141.5K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	124	190	1,000	$30	$139.9K

Showing 1–10 of 223

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsu Health Sciences Center Shreveport Faculty Group Practice	LA	Family Medicine Physician	$0	$235.7M
Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC	LA	Women's Hospital	$0	$15M
Innis Community Health Center, Inc	LA	Federally Qualified Health Center (FQHC)	$0	$13.9M
Baton Rouge Clinic, A Medical Corporation	LA	Internal Medicine Physician	$0	$10.3M
Brfhh Shreveport LLC	LA	General Acute Care Hospital	$0	$6.3M
Curana Health Of Louisiana LLC	LA	Family Medicine Physician	$0	$4.9M
Pavan Katikaneni	LA	Interventional Cardiology Physician	$1.3M	$0
Benjamin Close	LA	Pediatric Allergy/Immunology Physician	$381.9K	$688.8K
Joseph Nesheiwat	LA	Rheumatology Physician	$767.9K	$0
Wilson Baber	LA	Ophthalmology Physician	$756.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Care Solutions, Inc.	LA	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$49.8M
Ascent Health, Inc	LA	Community/Behavioral Health Agency	$0	$31.4M
Cognitive Development Center Personal Care Services	LA	Nursing Care Agency	$0	$27.8M
St Francis Medical Center, Inc	LA	General Acute Care Hospital	$0	$27.2M
Enrich Personal Care Services, LLC.	LA	Preferred Provider Organization	$0	$26.7M
Southern Center For Children And Families, Inc.	LA	Community/Behavioral Health Agency	$0	$24.5M
Afnb Home Care LLC	LA	In Home Supportive Care Agency	$0	$19.3M
D & D Community Connections	LA	Preferred Provider Organization	$0	$19.2M
Hearts Desire LLC	LA	In Home Supportive Care Agency	$0	$17.3M
Building Futures	LA	Speech-Language Pathologist	$0	$17M

Affinity Health Group, LLC — Billing Profile & Reimbursement Data

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Affinity Health Group, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References