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

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

Lgh Medical Group, Inc. (NPI 1174698385)

Lgh Medical Group, Inc. is a hospitalist physician provider located in Lowell, Massachusetts. This profile covers 0 Medicare and 89 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	Lgh Medical Group, Inc.
Address	295 Varnum Ave
City	Lowell
State	MA
ZIP	01854
Taxonomy	Hospitalist Physician
NPI Enumerated	November 22, 2006

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

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

89 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…	55,640	$50	$2.6M
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…	52,060	$40	$2M
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,900	$50	$191.2K
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…	3,610	$30	$97.4K
G0108	Diabetes outpatient self-management training services, individual, per 30 minutes	2,640	$30	$79.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,810	$20	$76.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	700	$100	$71.4K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	950	$60	$58.8K
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…	710	$80	$53.2K
J0585	Injection, onabotulinumtoxina, 1 unit	140	$350	$48.7K

Showing 1–10 of 89

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Lgh Medical Group, Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

89 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	215	520	120	$130	$1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	137	550	110	$120	$865.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	245	410	140	$110	$742.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	172	830	130	$120	$671K
J0585	Injection, onabotulinumtoxina, 1 unit	29	40	430	$490	$616K
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…	1,350	1,620	580	$80	$599.6K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	128	160	270	$130	$469.1K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	77	120	200	$180	$352.7K
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.	201	230	330	$70	$343.3K
J2315	Injection, naltrexone, depot form, 1 mg	18	20	70	$910	$297K

Showing 1–10 of 89

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Donald Sonn	MA	Urology Physician	$367.6K	$0
Lanny Xue	MA	Neurology Physician	$190.6K	$46.4K
Maher Tabba	MA	Pulmonary Disease Physician	$147K	$0
Andreas Schoeck	MA	Neurology Physician	$140.9K	$0
Jose Rodriguez Moreno	OR	Neurology Physician	$133K	$0
Matthew Cohen	MA	Urology Physician	$128.7K	$0
Min Zhu	MA	Neurology Physician	$124.7K	$0
David Shi	MA	Urology Physician	$118.5K	$0
Miguel Ariza	MA	Internal Medicine Physician	$95K	$21K
Mam Ibraheem	MA	Neurology Physician	$113.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Lowell General Hospital	MA	General Acute Care Hospital	$0	$159.6M
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$16.9M
Merrimack Valley Emergency Associates, Inc.	MA	Emergency Medicine Physician	$0	$15.1M
Sivaram Yamajala	MA	Internal Medicine Physician	$54.1K	$636K
Seema Sahib	MA	Internal Medicine Physician	$635.4K	$7.5K
Dragan Petakov	MA	Internal Medicine Physician	$102.4K	$107.9K
Naomi Jiang	MA	Radiation Oncology Physician	$150.1K	$0
Kevin Hewitt	MA	Diagnostic Neuroimaging (Radiology) Physician	$102.6K	$0
George Potamitis	MA	Physical Therapist	$83.2K	$0
Benson Mathew Abraham	MA	Internal Medicine Physician	$81.8K	$0

Lgh 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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