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.

Baptist Health Medical Group Inc (NPI 1093338527)

Baptist Health Medical Group Inc is a internal medicine physician provider located in Elizabethtown, Kentucky. This profile covers 0 Medicare and 195 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	Baptist Health Medical Group Inc
Address	2413 Ring Rd Ste 100
City	Elizabethtown
State	KY
ZIP	42701
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 19, 2020

Payer Source	Total Paid
Medicaid	$13.7M
Medicare	$0

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

195 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…	103,030	$40	$4.4M
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…	80,290	$30	$2.2M
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…	11,700	$60	$655K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	6,280	$90	$583.6K
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…	17,150	$30	$548.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	6,140	$70	$411.1K
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.	4,330	$90	$372.5K
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…	4,660	$70	$326.1K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	7,720	$40	$285.7K
J0585	Injection, onabotulinumtoxina, 1 unit	680	$410	$278.8K

Showing 1–10 of 195

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

Baptist Health Medical Group Inc — 4 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

195 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	96	180	1,870	$280	$1.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	71	80	7,740	$30	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	140	170	2,610	$250	$1M
J0585	Injection, onabotulinumtoxina, 1 unit	11	20	460	$540	$739.9K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	138	180	2,960	$110	$672.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	32	210	1,340	$160	$568K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	91	100	440	$320	$477.2K
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…	342	1,270	760	$80	$447.2K
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.	21	170	1,300	$230	$441K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	115	130	420	$270	$375.3K

Showing 1–10 of 195

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Health Deaconess Madisonville Inc	KY	Rural Acute Care Hospital	$0	$80.8M
Baptist Healthcare System, Inc.	KY	General Acute Care Hospital	$0	$58.5M
Baptist Health Medical Group Inc	KY	Nurse Practitioner	$0	$54.1M
Baptist Health Medical Group Inc	KY	Internal Medicine Physician	$0	$27.9M
Baptist Health Medical Group Inc	KY	Urgent Care Clinic/Center	$0	$26.7M
Baptist Health Medical Group Inc	KY	Family Medicine Physician	$0	$21.9M
Irfan Afaq	IN	Specialist	$84.2K	$6M
Peter Blackburn	KY	Retina Specialist (Ophthalmology) Physician	$1M	$251.2K
Artin Aharonian	MD	Diagnostic Radiology Physician	$1M	$0
Corey Hatfield	KY	Rheumatology Physician	$736.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$205.5M
Baptist Healthcare System Inc	KY	General Acute Care Hospital	$0	$95.7M
Stepworks Recovery Centers LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$67.7M
Communicare Inc	KY	Community/Behavioral Health Agency	$0	$49.5M
Hardin Memorial Hospital	KY	General Acute Care Hospital	$0	$37.2M
Pinnacle Treatment Centers Ky-1, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$33.6M
Lincoln Trail Area Development District	KY	Supports Brokerage Agency	$0	$31.4M
Astra Behavioral Health LLC	KY	Psychiatry Physician	$0	$26.1M
Renest Recovery Support Services	KY	Community/Behavioral Health Agency	$0	$19.9M
Elizabethtown Emergency Physicians, LLC	KY	Emergency Medicine Physician	$0	$11.9M

Baptist Health Medical Group Inc — 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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