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

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

Midwest Pain Clinic PC (NPI 1043482094)

Midwest Pain Clinic PC is a interventional pain medicine physician provider located in Omaha, Nebraska. This profile covers 0 Medicare and 28 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Midwest Pain Clinic PC
Address	825 N 90th St
City	Omaha
State	NE
ZIP	68114
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	March 31, 2008

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

28 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…	30,950	$40	$1.1M
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…	27,770	$30	$694.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3,460	$60	$190.2K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	1,430	$100	$144.5K
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…	11,050	$10	$77.4K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	130	$140	$18.3K
99152	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or…	1,220	$10	$14.6K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	190	$80	$14.5K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	120	$120	$14.5K
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…	190	$70	$13.4K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Midwest Pain Clinic PC — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	17	700	660	$70	$305.1K
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…	13	600	610	$70	$251.4K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	1	10	1,430	$100	$144.9K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	17	30	990	$20	$54K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	2	10	430	$110	$48.8K
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…	156	190	130	$70	$48.5K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2	10	480	$30	$48.3K
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…	58	130	130	$90	$43.8K
27096	The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…	2	10	130	$160	$32.6K
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,…	118	250	140	$60	$29.7K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keerthi Prasad	TX	Vascular & Interventional Radiology Physician	$666.7K	$0
Monish Merchant	FL	Vascular & Interventional Radiology Physician	$306.8K	$120
Stefan Franciosa	FL	Vascular & Interventional Radiology Physician	$266K	$0
David Welch	SD	Surgical Physician Assistant	$74.8K	$0
Rafal Krejza	NE	Interventional Pain Medicine Physician	$74.1K	$0
Stephanie Simon	NE	Family Nurse Practitioner	$60.8K	$0
Shelley Vanhoozer	NE	Nurse Practitioner	$60.5K	$0
Kevin Balter	NE	Interventional Pain Medicine Physician	$54.8K	$0
Bruce Watkins	ID	Surgery of the Hand (Surgery) Physician	$35.8K	$0
John Ashley	NE	Certified Registered Nurse Anesthetist	$19.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital & Medical Center	NE	Children's Hospital	$0	$89.8M
Children's Physicians	NE	Pediatrics Physician	$0	$39.4M
Nebraska Pediatric Practice, Inc	NE	Pediatrics Physician	$0	$29M
Physicians Clinic Inc	NE	Family Medicine Physician	$0	$20.5M
Nebraska Methodist Hospital	NE	General Acute Care Hospital	$0	$14.5M
Smiles 4 Kids PC	NE	General Practice Dentistry	$0	$11.5M
Children's Hospital	NE	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$8.4M
Nebraska Methodist Hospital	NE	Emergency Medicine Physician	$0	$5.3M
Unmc College Of Dentistry	NE	Dentist	$0	$4.8M
Stones Worth Stepping, P.C.	NE	Occupational Therapist	$0	$4.7M

Midwest Pain Clinic PC — Billing Profile & Reimbursement Data

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Midwest Pain Clinic PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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