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

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

Pain And Spine Specialists Of Maryland, LLC (NPI 1174884258)

Pain And Spine Specialists Of Maryland, LLC is a specialist provider located in Mount Airy, Maryland. This profile covers 0 Medicare and 31 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	Pain And Spine Specialists Of Maryland, LLC
Address	2702 Back Arce Circle
City	Mount Airy
State	MD
ZIP	21771
Taxonomy	Specialist
NPI Enumerated	June 5, 2012

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

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

31 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…	51,090	$40	$2.2M
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…	28,350	$70	$2M
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	20,090	$20	$422K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	27,100	$10	$216.8K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	260	$580	$151.5K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	1,690	$80	$130.1K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	690	$150	$101.9K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	1,590	$50	$77.8K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	1,170	$60	$71.2K
95923	In this procedure, the provider tests the sudomotor function of the autonomic nervous system to check functioning of nerves that supply sweat glands. The autonomic nervous system is that part of the…	980	$70	$70.6K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Pain And Spine Specialists Of Maryland, LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	64	160	980	$50	$387.6K
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…	44	3,670	680	$90	$310K
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	3,280	610	$80	$296.1K
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…	191	930	110	$100	$90.1K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	2	10	80	$450	$65.8K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	31	120	80	$160	$62K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	10	40	100	$90	$58.8K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	2	10	1,690	$30	$51.5K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	9	110	340	$50	$48.2K
95923	In this procedure, the provider tests the sudomotor function of the autonomic nervous system to check functioning of nerves that supply sweat glands. The autonomic nervous system is that part of the…	5	20	190	$60	$40.5K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nishant Gandhi	PA	Pain Medicine (Anesthesiology) Physician	$387.9K	$1M
Marcia Ribeiro	MD	Neurology Physician	$904.2K	$0
Sudhir Rao	MD	Pain Medicine (Anesthesiology) Physician	$700.5K	$89.4K
Keerthi Prasad	TX	Vascular & Interventional Radiology Physician	$666.7K	$0
Suhas Badarinath	MD	Physical Medicine & Rehabilitation Physician	$534K	$11.9K
Greg Hites	PA	Family Nurse Practitioner	$112.3K	$258.2K
Timothy Jones	SC	Family Nurse Practitioner	$117K	$191.8K
Monish Merchant	FL	Vascular & Interventional Radiology Physician	$306.8K	$120
Greesh John	MD	Pain Medicine (Anesthesiology) Physician	$300.8K	$0
Jennifer Sterbutzel	PA	Family Nurse Practitioner	$84.4K	$205.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pejman Rohani	MD	Vascular Surgery Physician	$1M	$0
Ingrid Zimmer-galler	MD	Retina Specialist (Ophthalmology) Physician	$580.8K	$0
Simcare Asc LLC	MD	Ambulatory Surgical Clinic/Center	$407.8K	$0
Edward Marshall	MD	Clinical Electrophysiology Physical Therapist	$234.3K	$0
Alpen Patel	MD	Otolaryngology Physician	$141.2K	$0
Sraddha Lamichhane	MD	Foot & Ankle Surgery Podiatrist	$125.9K	$0
Michael Tholen	MD	General Practice Physician	$93.5K	$0
Orchid Mesias	MD	Nurse Practitioner	$53.8K	$0

Pain And Spine Specialists Of Maryland, LLC — Billing Profile & Reimbursement Data

Sign up for Pain And Spine Specialists Of Maryland, LLC — Billing Profile & Reimbursement Data policy alerts

Pain And Spine Specialists Of Maryland, LLC — Billing Profile & Reimbursement Data

Sign up for Pain And Spine Specialists Of Maryland, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References