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

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

University Of Virginia Physicians Group (NPI 1033138250)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Of Virginia Physicians Group
Address	4105 Lewis And Clark Dr
City	Charlottesville
State	VA
ZIP	22911
Taxonomy	Sports Medicine (Neuromusculoskeletal Medicine) Physician
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicaid	$84.6M
Medicare	$0

This provider effectively operates as a Medicaid-focused practice: there is no Medicare billing on file and lifetime Medicaid revenue is $84.6M, so the organization’s public payer footprint is dominated by Medicaid with no measurable Medicare activity reported. That payer concentration means analyses of utilization and contracting should treat this entity as effectively single-payer (Medicaid) in scale and risk exposure.

Medicaid revenue is highly concentrated in outpatient evaluation-and-management (E/M) services: the top three Medicaid codes (99214, 99213, 99215) account for 59.5% of the provider’s total Medicaid revenue. Specifically, 99214 generated $22.2M (31.8%), 99213 generated $13.6M (19.5%), and 99215 generated $5.8M (8.2%), indicating most Medicaid dollars flow through established-patient office visits at varying complexity levels.

The code mix suggests a broad ambulatory and hospital-integrated operation rather than a narrow sports-medicine-only practice: high-volume E/M codes (99214/99213/99215) sit alongside emergency department visits (99284, 99285), hospital inpatient subsequent care (99233, 99232), neonatal critical care (99469, 99472), and a meaningful surgical pathology and imaging footprint (88305, 88307, 74177, , ). This pattern is consistent with an academic or multi-site group that manages routine outpatient care, ED throughput, inpatient follow-ups, and specialty diagnostics under one billing entity.

On competitive standing for ambulatory E/M the provider is a statewide leader: 99214 ranks #3 of 3523 providers in-state (100th percentile; extreme outlier), 99213 ranks #2 of 4012 providers in-state (100th percentile; extreme outlier), and 99215 ranks #1 of 605 providers in-state (100th percentile; extreme outlier). Those rank/percentile positions indicate this organization is a dominant in-state source of high-volume established patient visits and handles an unusually large share of those Medicaid encounters compared with peers.

Preventive and pediatric well-care services are also a major component of volume: 99391 ($2.6M, ranks #2 of 578 providers in-state; 100th percentile; extreme outlier) and 99392 ($2.5M, ranks #1 of 646 providers in-state; 100th percentile; extreme outlier) together represent sizable Medicaid revenue and signal a strong well-child/ preventive medicine program. Coupled with 99393 (established child visits) at $777.5K and rank #5 of 627 (99th percentile; extreme outlier), the data point to sustained pediatric/preventive throughput.

The provider maintains significant inpatient, critical care, and neonatal service lines within its Medicaid activity: 99233 ($2M, ranks #6 of 285; 98th percentile; notably above typical), 99232 ($1.4M, ranks #11 of 398; 97th percentile; notably above typical), 99291 ($574.4K, ranks #10 of 134; 93rd percentile; typical), and neonatal codes 99469 ($1.8M, ranks #2 of 14; 92nd percentile; typical) and 99472 ($834.7K, ranks #2 of 6; 80th percentile; typical). These codes show the provider is not just outpatient-facing but also captures substantial inpatient and critical/neonatal care volume under Medicaid.

Ancillary and diagnostic services are material and centralized: surgical pathology 88305 ($1.4M, ranks #6 of 158; 97th percentile; extreme outlier) and 88307 ($491K, ranks #3 of 65; 97th percentile; notably above typical), imaging codes 74177 ($1.1M, ranks #9 of 178; 95th percentile; notably above typical) and 70553 ($690K, ranks #3 of 87; 98th percentile; extreme outlier), and echocardiography 93306 ($1M, ranks #4 of 211; 99th percentile; extreme outlier) demonstrate an integrated diagnostics footprint that drives non-E/M Medicaid revenue. This suggests internal capture of downstream testing rather than reliance on outside imaging/pathology vendors for a substantial portion of billed services.

The provider has a long tenure in the NPI registry (NPI enumerated 2006-07-19 (~20 years ago)), which, combined with the extreme outlier rankings across many Medicaid codes, implies established referral patterns and an entrenched role in statewide Medicaid care delivery. Analysts should view this as a mature, institutionally-scaled provider whose strategic negotiating and network value will be driven primarily by Medicaid volumes and services rather than Medicare exposure.

Medicaid: Complete Services Breakdown

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

386 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…	364,320	$60	$22.2M
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…	266,930	$50	$13.6M
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…	61,960	$90	$5.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	48,690	$60	$3.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	33,920	$90	$3M
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…	36,450	$70	$2.6M
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…	32,540	$80	$2.5M
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…	35,360	$60	$2M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	8,090	$220	$1.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	45,450	$30	$1.4M

Showing 1–10 of 386

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

University Of Virginia Physicians Group — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

386 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	2	10	1,430	$260	$1.7M
G9012	Other specified case management service not elsewhere classified	61	120	2,160	$220	$1.6M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	27	340	160	$130	$1.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	75	630	90	$140	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	90	140	3,240	$160	$1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	32	620	70	$120	$1M
J0585	Injection, onabotulinumtoxina, 1 unit	20	20	750	$540	$871.7K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	10	50	$250	$835.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	9	180	2,950	$140	$783.2K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	24	80	650	$210	$752.6K

Showing 1–10 of 386

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rector & Visitors Of The University Of Virginia	VA	General Acute Care Hospital	$0	$500.4M
Mcv Associated Physicians	VA	Anesthesiology Physician	$0	$99M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Rector & Visitors Of The University Of Virginia	VA	Home Infusion Agency	$0	$10.3M
Ashley Blurton	VA	Nuclear Medicine Physician	$2.9M	$0
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Robert Olk	MO	Ophthalmology Physician	$1.7M	$0
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Yevgeniy Shildkrot	VA	Ophthalmology Physician	$1.5M	$0
Sanjeev Aggarwal	VA	Radiation Oncology Physician	$1.4M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compass Youth Services	VA	Community/Behavioral Health Agency	$0	$63.5M
Martha Jefferson Hospital	VA	General Acute Care Hospital	$0	$26.9M
Addiction Recovery Systems LLC	VA	Methadone Clinic	$127.5K	$11.5M
Children's Dentistry Of Charlottesville, P.C.	VA	Dentist	$0	$11M
Mohit Nanda	VA	Retina Specialist (Ophthalmology) Physician	$4.6M	$0
Jacob Meyer	VA	Retina Specialist (Ophthalmology) Physician	$3.8M	$0
Scott Chirichetti	VA	Pain Medicine Physician	$1.1M	$0
Stephen Vance	VA	MOHS-Micrographic Surgery Physician	$924.6K	$0
Vandana Nanda	VA	MOHS-Micrographic Surgery Physician	$912.2K	$0
Richard Messinger	VA	Pain Medicine Physician	$489.7K	$0

University Of Virginia Physicians Group — 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