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

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

Macoupin Family Practice Center, LLP (NPI 1194915074)

Macoupin Family Practice Center, LLP is a family medicine physician provider located in Gillespie, Illinois. This profile covers 0 Medicare and 14 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	Macoupin Family Practice Center, LLP
Address	715 Broadway St
City	Gillespie
State	IL
ZIP	62033
Taxonomy	Family Medicine Physician
NPI Enumerated	July 27, 2007

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	41,940	$70	$2.9M
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	430	$0	$0
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	480	$0	$0
90832	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…	50	$0	$0
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	20	$0	$0
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	270	$0	$0
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…	70	$0	$0
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…	12,760	$0	$0
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…	13,560	$0	$0
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	30	$0	$0

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Macoupin Family Practice Center, LLP — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	166	850	7,490	$120	$3.9M
90832	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…	792	960	330	$30	$51K
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…	96	14,680	300	$50	$48.7K
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…	1,008	1,380	370	$40	$46.2K
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…	279	14,190	280	$20	$38.9K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	661	1,540	410	$20	$30.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	745	1,670	160	$40	$26.4K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	1,452	1,590	360	$10	$23K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	525	1,590	110	$40	$21.4K
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…	1,247	2,800	60	$80	$17.7K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unity Healthcare	IA	General Acute Care Hospital	$0	$12.7M
Springfield Clinic, LLP	IL	Clinical Medical Laboratory	$3.5M	$7.4M
Springfield Clinic, LLP	IL	Rural Health Clinic/Center	$0	$9.4M
Aleksandr Kagan	IL	Ophthalmology Physician	$2.8M	$1.5M
Springfield Clinic LLP	IL	Ambulatory Surgical Clinic/Center	$3.5M	$0
Robert Lowenthal	IL	Ophthalmology Physician	$3.2M	$62.6K
Lanny Odin	IL	Ophthalmology Physician	$2.5M	$406.4K
Ramanath Bhandari	IL	Ophthalmology Physician	$2.5M	$144.9K
Timothy Gillison	IL	Hematology & Oncology Physician	$1.7M	$54.1K
Scott Mink	IL	Hematology & Oncology Physician	$1.6M	$60.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Macoupin County Public Health Department	IL	Federally Qualified Health Center (FQHC)	$0	$9.8M
Gillespie-benld Area Ambulance Service, Inc.	IL	Land Ambulance	$806.2K	$2.9M

Macoupin Family Practice Center, LLP — Billing Profile & Reimbursement Data

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Macoupin Family Practice Center, LLP — 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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