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 Wyoming for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Wyoming 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. Wyoming (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.

Pain Care Center, LLC (NPI 1023398906)

Field	Value
Entity Type	Organization
Organization	Pain Care Center, LLC
Address	2620 Commercial Way Ste 20
City	Rock Springs
State	WY
ZIP	82901
Taxonomy	Pain Medicine (Anesthesiology) Physician
NPI Enumerated	August 23, 2011

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

Key Findings

PAIN CARE CENTER, LLC is effectively a Medicaid-focused practice: there is no Medicare billing on file and total Medicaid revenue is $1.6M, so Medicaid accounts for the entirety of reported lifetime public-payer revenue for this NPI. This single-payer footprint limits direct comparisons across Medicare and Medicaid lines and suggests the provider’s operational focus is on state Medicaid populations rather than mixed Medicare/Medicaid panels.

Revenue is extremely concentrated in a narrow set of evaluation-and-management and testing services: the top 3 Medicaid codes (99214, 80305, 76942) together account for 95.3% of the provider’s total Medicaid revenue. In particular, 99214 alone generates $1.3M revenue (82.7% of this provider's total Medicaid revenue), indicating that most revenue is driven by one high-volume E&M code.

The provider’s case mix and top codes indicate an office-based pain management model focused on frequent, extended follow-up visits and routine point-of-care monitoring. Code 99214 (25K claims, $53 avg paid/claim, $1.3M revenue) reflects frequent established-patient visits with moderate medical decision making or 30+ minutes per encounter, while 80305 (21.2K claims, $8 avg paid/claim, $169.6K revenue) shows a very large volume of presumptive drug testing consistent with chronic pain medication monitoring.

Competitive standing in-state is dominant for the practice’s primary codes: 99214 ranks #2 of 223 providers in-state and is labeled an extreme outlier (100th percentile), and 80305 ranks #1 of 7 providers in-state and is described as notably above typical state volume (100th percentile). These rankings indicate the provider is a major statewide participant for its top revenue-driving services, especially for extended E&M visits and point-of-care drug testing.

Procedure and procedure-support codes are present but represent a small share of revenue and appear secondary to clinic visits and testing. 76942 (498 claims, $64 avg paid/claim, $31.9K revenue, 2.0% of total) and A4550 (1.8K claims, $14 avg paid/claim, $24.8K revenue, 1.6% of total) indicate limited use of ultrasound guidance and surgical tray supplies, suggesting some in-office interventional procedures but at much lower volume than E&M and testing.

The coding mix (high-volume 99214 and 80305) implies a clinical workflow emphasizing repeated patient encounters and routine toxicology screening; this pattern is typical for chronic pain management practices that monitor controlled-substance therapy. High counts for 99214 (25K claims) and 80305 (21.2K claims) signal heavy per-encounter throughput rather than a primary focus on high-reimbursement surgical or implantable-device procedures.

Concentration risk is material: because the single top code 99214 represents $1.3M and 82.7% of Medicaid revenue, changes in coverage policy, coding edits, or utilization review focused on that code could materially affect the provider’s Medicaid revenue. The provider’s dependence on a small number of services (the top 3 codes = 95.3% of revenue) increases sensitivity to payer policy shifts affecting E&M or drug-screening reimbursement.

The NPI has been enumerated since 2011-08-23 (~15 years ago), indicating a stable operational tenure in the market. Ten-plus years of billing history combined with the provider’s current statewide rank positions them as an established regional operator in Medicaid-funded pain management services.

Medicaid: Complete Services Breakdown

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

16 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…	24,950	$50	$1.3M
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	21,200	$10	$169.6K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	500	$60	$31.9K
A4550	Surgical trays	1,770	$10	$24.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	240	$70	$15.5K
E0720	Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation	60	$150	$9.5K
A4595	Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)	230	$30	$6.1K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,720	$1	$5.2K
20553	Trigger point injection, or TPI, is a medical procedure in which the provider injects an anesthetic or corticosteroid substance into three or more muscles to relieve painful areas or knots in muscles…	170	$30	$4.5K
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…	100	$30	$3.3K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Pain Care Center, LLC — 4 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

16 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…	2	220	400	$50	$79.3K
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…	194	260	420	$30	$67.2K
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…	13	30	30	$110	$35.2K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	1	10	500	$60	$31.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	1	10	660	$10	$25.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	6	40	80	$90	$15.7K
A4550	Surgical trays	1	10	970	$20	$14.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	35	70	70	$20	$10.2K
E0720	Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation	1	10	60	$150	$9.5K
A4595	Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)	1	10	230	$30	$6.1K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pain Care Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Campbell	WY	Physical Medicine & Rehabilitation Physician	$164.2K	$0
Brenda Barker	WY	Family Nurse Practitioner	$107.6K	$0
Marie Bohrer	WY	Family Nurse Practitioner	$78.3K	$0
Sharlotte Shore	WY	Family Nurse Practitioner	$72.1K	$0
Jennifer Rosics	WY	Medical Physician Assistant	$71.5K	$0
Kelly Plessman	WY	Family Nurse Practitioner	$61.2K	$0
Kelsie Anderson	WY	Family Nurse Practitioner	$51.3K	$0
Trisha Rose	WY	Family Nurse Practitioner	$48.3K	$0
Jill Bass	WY	Clinical Nurse Specialist	$43.7K	$0
Laura Wells	WY	Family Nurse Practitioner	$22.2K	$10.7K

Nearby Providers

Other providers in the same ZIP code as Pain Care Center, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lsw, LLC	WY	Developmentally Disabled Services Day Training Agency	$0	$11.6M
Able Hands	WY	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Sweetwater Pediatrics P.C.	WY	Primary Care Clinic/Center	$0	$2M
Southwest Counseling Service	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.5M
Qrc LLC	WY	Case Management Agency	$0	$1.4M
University Of Utah Adult Services	WY	Emergency Medicine Physician	$0	$1.2M
Lcr Dental Rock Springs LLC	WY	Dentist	$0	$1.1M
Memorial Hospital Of Sweetwater County	WY	Internal Medicine Physician	$0	$1.1M
Aai Services LLC	WY	Case Management Agency	$0	$971.4K
Nicole Armstrong	WY	Case Manager/Care Coordinator	$0	$773.2K

Pain Care Center, LLC — Billing Profile & Reimbursement Data

Sign up for Pain Care Center, LLC — Billing Profile & Reimbursement Data policy alerts

Pain Care Center, LLC — Billing Profile & Reimbursement Data

Sign up for Pain Care Center, LLC — Billing Profile & Reimbursement Data policy alerts

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