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.

Metrospine PC (NPI 1194844357)

Metrospine PC is a specialist provider located in Oxon Hill, Maryland. This profile covers 0 Medicare and 52 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	Metrospine PC
Address	6196 Oxon Hill
City	Oxon Hill
State	MD
ZIP	20745
Taxonomy	Specialist
NPI Enumerated	March 28, 2007

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

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

52 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…	30,620	$60	$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…	14,490	$80	$1.1M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	9,630	$110	$1.1M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3,700	$100	$355.3K
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…	1,080	$120	$132.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	12,060	$10	$84.4K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	1,060	$70	$74.3K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	420	$130	$53.1K
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).	270	$180	$48.8K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	500	$80	$37.6K

Showing 1–10 of 52

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

Metrospine PC — 5 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

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	24	50	3,420	$110	$1.2M
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…	147	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…	57	3,280	610	$80	$296.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	361	480	740	$50	$220.2K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2	20	410	$80	$144.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	467	570	810	$30	$138K
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…	151	930	110	$100	$90.1K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	13	10	220	$60	$88.8K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	11	50	270	$60	$87.4K
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).	15	40	100	$90	$58.8K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
George Drakes	MD	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$440.9K	$24.6K
Ai Huong Phu	IA	Physical Medicine & Rehabilitation Physician	$154.7K	$0
Sarian Wilson	MD	Nurse Practitioner	$95.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
All Thats Therapeutic Inc	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.7M
Moore Obgyn LLC	MD	Obstetrics & Gynecology Physician	$0	$23.2M
Ib Dental Ii, P.C.	MD	General Practice Dentistry	$0	$10.5M
Tanek L. Jenkins, Dds	MD	Pediatric Dentistry	$0	$9.8M
Nspc Surgery Center Of Maryland LLC	MD	Ambulatory Surgical Clinic/Center	$5.8M	$6.3K
All That's Therapeutic, Inc.	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.3M
Utopian Institute Of Family Living LLC	MD	Community/Behavioral Health Agency	$0	$4.6M
Surgcenter At National Harbor, LLC	MD	Ambulatory Surgical Clinic/Center	$2.8M	$0
Vipul Mangal	MD	Pain Medicine (Anesthesiology) Physician	$2.2M	$0
Potomac Urology Surgery Center, LLC	MD	Ambulatory Surgical Clinic/Center	$624.4K	$0

Metrospine PC — Billing Profile & Reimbursement Data

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Metrospine PC — 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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