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

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

Primary Care Group LLC (NPI 1093016651)

Primary Care Group LLC is a family medicine physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 231 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	Primary Care Group LLC
Address	1211 Union Ave Ste 200
City	Memphis
State	TN
ZIP	38104
Taxonomy	Family Medicine Physician
NPI Enumerated	November 12, 2010

Payer Source	Total Paid
Medicaid	$23.5M
Medicare	$0

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

231 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	139,540	$40	$5.4M
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…	145,020	$30	$4.5M
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.	66,810	$50	$3.3M
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…	26,760	$80	$2M
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…	22,440	$70	$1.5M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	13,820	$70	$1M
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	7,410	$80	$607.9K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	6,700	$80	$502.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,810	$80	$482K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	7,450	$50	$357.6K

Showing 1–10 of 231

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Primary Care Group LLC — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

231 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	213	360	350	$50	$414.4K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	58	100	670	$60	$342.9K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	25	30	480	$20	$283.4K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	6	40	200	$20	$234.7K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	29	30	700	$10	$227.5K
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…	56	300	480	$30	$221.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	26	150	390	$60	$220.9K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	44	70	250	$20	$215.6K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	50	70	270	$20	$215.5K
86235	The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,…	5	10	1,180	$20	$209.4K

Showing 1–10 of 231

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Methodist Healthcare - Memphis Hospitals	TN	General Acute Care Hospital	$0	$105.6M
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$84.4M
Ut Lebonheur Pediatric Specialists, Inc.	TN	Pediatrics Physician	$0	$63.8M
Methodist Healthcare - Olive Branch Hospital	MS	General Acute Care Hospital	$0	$18.1M
Alliance Health Services Inc.	TN	Durable Medical Equipment & Medical Supplies	$0	$11.2M
Methodist Inpatient Physicians LLC	TN	Internal Medicine Physician	$0	$4.8M
Lebonheur Patient Transportation	TN	Land Ambulance	$0	$4.5M
Specialty Physician Group LLC	TN	Cardiovascular Disease Physician	$0	$3.3M
Methodist Healthcare - Memphis Hospitals	TN	Children's Hospital	$0	$3.3M
Ut Methodist Physicians LLC	TN	Internal Medicine Physician	$0	$2.7M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Well Child Inc.	TN	Nurse Practitioner	$0	$19.8M
Bhg Reference Lab, LLC	TN	Clinical Medical Laboratory	$0	$14M
Wci School Health Services, PLLC	TN	Family Nurse Practitioner	$0	$10.4M
Memphis Radiological, P.C.	TN	Diagnostic Radiology Physician	$0	$9.1M
Memphis Medical Center Air Ambulance Service, Inc.	TN	Air Ambulance	$0	$6.5M
Southern College Of Optometry	TN	Optometrist	$0	$5.4M
Satellite Healthcare Of Poplar Avenue LLC	TN	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$5.2M
Phillip R. Bowden, M.d.,p.a.	TN	Gastroenterology Physician	$0	$4.6M
Memphis Recovery Centers, Inc.	TN	Substance Abuse Rehabilitation Facility	$0	$4.6M
Bianca Sweeten	TN	Pediatrics Physician	$0	$3.2M

Primary Care Group LLC — Billing Profile & Reimbursement Data

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Primary Care Group LLC — 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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