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

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

Bardstown Primary Care, PLLC (NPI 1053305524)

Bardstown Primary Care, PLLC is a rural health clinic/center provider located in Bardstown, Kentucky. This profile covers 0 Medicare and 113 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	Bardstown Primary Care, PLLC
Address	201 S 5th St
City	Bardstown
State	KY
ZIP	40004
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 9, 2005

Payer Source	Total Paid
Medicaid	$11.7M
Medicare	$0

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

113 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…	60,550	$60	$3.3M
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…	66,840	$40	$2.3M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	15,200	$30	$425.6K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	27,530	$20	$413K
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…	5,900	$70	$389.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	15,770	$20	$299.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	4,260	$70	$294K
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…	4,880	$60	$292.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,460	$70	$290.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	6,140	$50	$276.3K

Showing 1–10 of 113

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Bardstown Primary Care, PLLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

113 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	188	200	1,610	$80	$585.6K
90887	In this service, the provider interprets or explains the results of psychiatric exams, medical exams, other procedures, or information about the patient’s care to the patient’s family members or…	113	140	460	$70	$475.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	245	1,270	760	$80	$447.2K
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…	77	3,340	1,020	$30	$296K
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…	32	2,460	580	$40	$245K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	248	600	600	$40	$207.8K
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…	38	230	720	$60	$180.1K
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…	26	260	540	$70	$176.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	265	330	1,400	$30	$156.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	80	500	250	$60	$152.8K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Almcare, LLC	KY	Developmentally Disabled Services Day Training Agency	$0	$31M
Flaget Healthcare, Inc	KY	General Acute Care Hospital	$0	$26.5M
Active Day Ky, Inc.	KY	Adult Day Care Clinic/Center	$0	$7.7M
County Of Nelson	KY	Land Ambulance	$798.9K	$1.3M
James Ferrara	KY	Occupational Therapist	$345.2K	$0
Sanjiv Mehta	KY	Orthopaedic Surgery Physician	$262.9K	$0
Kelli Morgan	KY	Dermatology Physician	$185.6K	$0
Andrea Stucker	KY	Physician Assistant	$134.8K	$0
C & G Pharmacy LLC.	KY	Community/Retail Pharmacy	$96.7K	$0
Wal-mart Stores East LP	KY	Community/Retail Pharmacy	$80.4K	$0

Bardstown Primary Care, PLLC — Billing Profile & Reimbursement Data

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Bardstown Primary Care, PLLC — 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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