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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

United Physicians Care Inc (NPI 1184849200)

Key Findings

Field	Value
Entity Type	Organization
Organization	United Physicians Care Inc
Address	686 S Pike St
City	Shinnston
State	WV
ZIP	26431
Taxonomy	Family Medicine Physician
NPI Enumerated	April 16, 2007

Payer Source	Total Paid
Medicaid	$18.5M
Medicare	$0

UNITED PHYSICIANS CARE INC reports $18.5M in lifetime Medicaid revenue and has no Medicare billing on file, making its revenue effectively single-payer Medicaid–dependent. This concentration means payer-policy or rate changes within Medicaid could materially impact the practice’s topline, since there is no Medicare offset reported in the data set.

Revenue is highly concentrated in a few E/M codes: the top three Medicaid codes (99213, 99214, 99232) account for 56.4% of this provider’s total Medicaid revenue. Individually these are 99213 ($4.3M, 25.6%), 99214 ($4.2M, 25.1%), and 99232 ($963.6K, 5.7%), showing that routine office E/M visits drive the majority of billed Medicaid dollars.

The claim volumes and average paid/claim for 99213 (71K claims, $61 avg paid/claim) and 99214 (55.1K claims, $77 avg paid/claim) indicate a very high outpatient throughput consistent with a high-volume family medicine primary care clinic. The presence of 19.7K claims for 99232 (inpatient subsequent care) further suggests the operation includes substantial hospital follow-up work in addition to ambulatory visits.

Preventive services are a clear service-line strength: 99392 (11.4K claims, $908.5K, 5.4%) ranks #3 of 146 providers in-state (99th percentile; extreme outlier) and 99391 (11.8K claims, $849.2K, 5.0%) ranks #2 of 137 (99th percentile; extreme outlier). These volumes, together with multiple well-patient visit codes across age groups (99393, 99394, 99395, 99396), point to a sustained emphasis on comprehensive preventive care and routine well-child/adult visits.

Immunizations and developmental screening are billed at scale: 96110 shows 27.2K claims ($380.4K, 2.2%) and ranks #2 of 121 providers in-state (99th percentile; extreme outlier), while vaccine administration codes 90471 (22.6K claims, $316K) and 90472 (14.7K claims, $338.2K) both rank in the top 4 statewide (98–99th percentiles; extreme outlier/notably above typical). This mix supports a practice workflow that integrates screening and vaccine delivery as core, high-volume services.

Against in-state peers the provider is a volume leader on multiple codes: 99213 ranks #16 of 1273 providers in-state (99th percentile; extreme outlier) and 99214 ranks #11 of 1031 (99th percentile; notably above typical). Those percentile placements indicate the practice is a dominant Medicaid-volume provider for routine E/M visits relative to most West Virginia peers.

While core E/M and preventive codes are outliers, several hospital and ED codes are within typical ranges: 99232 is 95th percentile (rank #11 of 185; typical, unremarkable), and ED codes 99283 and 99285 fall in the 77th and 69th percentiles respectively. This pattern suggests a mixed-service footprint—heavy ambulatory and preventive care with a meaningful, but not exceptional, level of inpatient and emergency work.

The NPI was enumerated on 2007-04-16 (~19 years ago), indicating long tenure in the market. Combined with the very large claim volumes across primary care, preventive, vaccination, and developmental screening codes, the data point to an established practice infrastructure that supports high-throughput Medicaid care delivery, but with exposure concentrated in Medicaid reimbursement dynamics.

Medicaid: Complete Services Breakdown

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

136 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…	71,000	$60	$4.3M
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…	55,100	$80	$4.2M
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…	19,670	$50	$963.6K
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…	11,360	$80	$908.5K
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…	11,800	$70	$849.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,620	$80	$522.7K
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.	11,190	$50	$514.6K
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.	4,910	$100	$490.7K
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…	5,160	$80	$386.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,930	$130	$380.8K

Showing 1–10 of 136

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

United Physicians Care Inc — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

136 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.	41	130	2,090	$210	$1.5M
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.	80	170	3,350	$120	$1.1M
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.	39	160	3,690	$80	$714.8K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	15	30	2,810	$100	$340.9K
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	1,270	1,240	$30	$245K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	46	140	3,080	$20	$243.1K
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…	11	190	660	$40	$226.4K
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…	11	1,030	890	$50	$221K
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…	29	60	170	$130	$189.3K
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…	12	80	580	$60	$182K

Showing 1–10 of 136

United Physicians Care Inc — Billing Profile & Reimbursement Data

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United Physicians Care Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abdulmalek Sabbagh	WV	Cardiovascular Disease Physician	$208.6K	$0
Cathy Funk	WV	Internal Medicine Physician	$175.6K	$0
John Angotti	WV	Internal Medicine Physician	$162.3K	$0
James Malone	WV	Family Medicine Physician	$160.6K	$0
Ebrahim Sabbagh	WV	Interventional Cardiology Physician	$156.8K	$0
Michael Johnson	WV	Family Medicine Physician	$155.9K	$0
Isha Woofter	WV	Family Medicine Physician	$120.9K	$0
Kelly Nelson	WV	Family Medicine Physician	$114.2K	$0
Dominick Woofter	WV	Family Medicine Physician	$111.9K	$0
Christopher Courtney	WV	Adult Reconstructive Orthopaedic Surgery Physician	$106.9K	$0