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.

Gastroenterology Specialties, P.C. (NPI 1083747380)

Gastroenterology Specialties, P.C. is a specialist provider located in Lincoln, Nebraska. This profile covers 0 Medicare and 10 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	Gastroenterology Specialties, P.C.
Address	4545 R St
City	Lincoln
State	NE
ZIP	68503
Taxonomy	Specialist
NPI Enumerated	March 14, 2007

Payer Source	Total Paid
Medicaid	$960.3K
Medicare	$0

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4,510	$170	$757.5K
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…	3,510	$40	$154.6K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	250	$70	$17K
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…	200	$80	$16K
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…	160	$30	$5.2K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	30	$130	$3.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	10	$150	$1.8K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	540	$1	$1.6K
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…	60	$30	$1.6K
00812	The provider performs anesthesia services for a patient undergoing a screening colonoscopy during which the surgical provider introduces an endoscope into the intestines below the duodenum, the part…	10	$110	$1.5K

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

Gastroenterology Specialties, P.C. — 0 of 10 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

10 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…	571	700	660	$70	$305.1K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	16	30	280	$450	$266.7K
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…	108	600	610	$70	$251.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	11	50	1,140	$60	$200K
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…	33	50	670	$30	$186.5K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	8	10	180	$290	$96.4K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	17	20	100	$320	$82.5K
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…	56	130	130	$90	$43.8K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	7	40	200	$1	$1.9K
00812	The provider performs anesthesia services for a patient undergoing a screening colonoscopy during which the surgical provider introduces an endoscope into the intestines below the duodenum, the part…	1	10	10	$110	$1.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jean Thomsen	IA	Anatomic Pathology & Clinical Pathology Physician	$346.3K	$30.2K
Mark Griffin	NE	Specialist	$343K	$0
Kerry Bernal	NE	Anatomic Pathology & Clinical Pathology Physician	$309K	$0
David Newton	NE	Gastroenterology Physician	$298.6K	$0
William Lawton	NE	Gastroenterology Physician	$295.1K	$0
Mark Wells	NE	Gastroenterology Physician	$265.3K	$0
Matthew Hrnicek	NE	Gastroenterology Physician	$263.9K	$0
Clark Antonson	NE	Gastroenterology Physician	$263.2K	$0
John Thomas	NE	Gastroenterology Physician	$250.7K	$0
Paul Petersen	NE	Specialist	$246.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$12.6M
Centerpointe, Inc.	NE	Addiction (Substance Use Disorder) Counselor	$0	$4.3M
Tr Hepburn Inc	NE	Assisted Living Facility (Mental Illness)	$0	$3.7M
Heartland Optical Inc.	NE	Optometrist	$0	$3.5M
Lincoln Endoscopy Center, LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$612.5K
Centerpointe, Inc.	NE	Mental Illness Community Based Residential Treatment Facility	$0	$2.1M
Renal Treatment Centers-illinois Inc.	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$970.8K
Youniq Health LLC	NE	Psychiatric/Mental Health Nurse Practitioner	$0	$804.4K
Gregory Utecht	NE	Dentist	$0	$527.9K
Nebraska Specialty Network, LLC	NE	Cardiovascular Disease Physician	$0	$361.2K

Gastroenterology Specialties, P.C. — Billing Profile & Reimbursement Data

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Gastroenterology Specialties, P.C. — 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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