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.

Lexington Regional Health Center (NPI 1104228451)

Lexington Regional Health Center is a rural health clinic/center provider located in Lexington, Nebraska. This profile covers 0 Medicare and 22 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	Lexington Regional Health Center
Address	1105 N Erie St
City	Lexington
State	NE
ZIP	68850
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 18, 2014

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

22 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…	16,400	$110	$1.8M
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…	7,890	$140	$1.1M
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…	970	$80	$80.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	4,880	$20	$73.2K
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…	210	$160	$33.2K
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,…	500	$70	$32.6K
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…	60	$170	$10K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	500	$20	$9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	290	$30	$7.1K
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…	70	$90	$6.1K

Showing 1–10 of 22

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

Lexington Regional Health Center — 1 of 22 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

22 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…	31	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…	46	600	610	$70	$251.4K
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…	24	70	360	$80	$234.7K
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…	47	70	230	$90	$222.7K
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…	508	510	450	$100	$168.1K
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…	442	510	440	$140	$155.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	85	90	100	$80	$54.7K
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…	39	40	530	$20	$53.8K
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…	78	190	130	$70	$48.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	68	110	70	$100	$43.2K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lexington Regional Health Center	NE	Critical Access Hospital	$0	$4.2M
Lexington Regional Health Center	NE	Rural Health Clinic/Center	$0	$459.5K
Matthew Rutman	NY	Urology Physician	$277.1K	$39.9K
Lexington Regional Health Center	NE	Emergency Medicine Physician	$0	$293.5K
Joseph Kummer	NE	Cardiovascular Disease Physician	$286.5K	$0
Emily Jones	NE	Family Medicine Physician	$185.9K	$0
Joshua Wray	NE	Foot & Ankle Surgery Podiatrist	$137.7K	$0
Matthew Pouliot	CO	Pain Medicine Physician	$123.5K	$0
Thomas Saylor	FL	Orthopaedic Surgery Physician	$98.7K	$0
Anthony Cook	IA	Family Medicine Physician	$74.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Plum Creek Medical Group, P.C.	NE	Family Medicine Physician	$0	$2.5M
Lexington Family Eyecare	NE	Optometrist	$0	$779.3K
Lawton Counseling, LLC	NE	Mental Health Counselor	$0	$306.8K
Mayra Avalos	NE	Mental Health Counselor	$0	$276.7K
Thomas G Fagot Dds PC	NE	General Practice Dentistry	$0	$254.6K
Raime Misko	NE	Family Nurse Practitioner	$67K	$0
Rebecca Gill	NE	Surgery Physician	$44.7K	$0
Jason Seim	NE	Optometrist	$42.7K	$0

Lexington Regional Health Center — Billing Profile & Reimbursement Data

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Lexington Regional Health Center — 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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