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

Why is the Medicaid comparison limited to 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. 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.

Medexpress Urgent Care, PC - Virginia (NPI 1215219878)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medexpress Urgent Care, PC - Virginia
Address	4003 College Ave
City	Bluefield
State	VA
ZIP	24605
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	September 9, 2011

Payer Source	Total Paid
Medicaid	$50.6M
Medicare	$0

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file and lifetime Medicaid revenue totals $50.6M. The NPI was enumerated on 2011-09-09 (~15 years ago), indicating over a decade of billing history concentrated in the Medicaid program.

Revenue is highly concentrated in a small set of Evaluation & Management codes: the precomputed top three Medicaid codes (99214, 99213, 99203) account for 71.8% of this provider's total Medicaid revenue. Those codes alone represent $15M (99214, 30.1%), $12.3M (99213, 24.7%), and $8.4M (99203, 17.0%), signaling that office/outpatient visits are the primary revenue drivers.

The code mix strongly indicates an urgent care / high-throughput ambulatory clinic model: very large volumes of established- and new-patient E/M codes (99214: 192K claims; 99213: 201.4K claims; 99203: 114.1K claims) combined with urgent-care specific codes S9088 and S9083 point to routine episodic care, same-day visits, and throughput-focused workflows. Frequent use of point-of-care infectious-disease tests (e.g., 87426, 87804, 87880, 87811) and basic radiology supports an on-site diagnostic capability typical of urgent care centers.

On competitive standing within Virginia this provider is a major outlier for core visit codes: 99214 ranks #10 of 3523 providers in-state (100th percentile; extreme outlier), 99213 ranks #6 of 4012 (100th percentile; extreme outlier), and 99203 ranks #1 of 1001 (100th percentile; extreme outlier). Those ranks indicate the provider is among the highest-volume Medicaid billers for both established- and new-patient visits in the state, consistent with a dominant regional presence for urgent care E/M services.

Diagnostic testing is a distinct strength: 87426 ($2.1M, 81K claims) and 87804 ($1.9M, 155.8K claims) both rank #1 in-state (100th percentile; extreme outlier), and 87880 ($1.3M) and 87811 ($1M) also rank at the top of their peer sets. High state-ranking and sizable revenue from these lab codes indicate the provider performs very large volumes of COVID/respiratory and rapid infectious testing relative to other in-state Medicaid providers.

Ancillary services and supplies are meaningful secondary revenue streams: chest X-ray 71046 generated $202.6K, injection code 96372 $191.9K, pregnancy testing 81025 $118.8K, and DME codes such as L4350 ($156.2K) and E0114 ($115.9K) appear in the top-25 list. Several of these codes rank above typical state volume (e.g., 96372 ranks #23 of 514 at the 96th percentile), suggesting the clinic also captures revenue from basic imaging, procedures, and off-the-shelf braces/crutches commonly needed in urgent care.

Given the provider’s dependence on a small set of high-volume codes (71.8% concentrated in 99214/99213/99203) and absence of Medicare billing, its financial profile is highly Medicaid-dependent and concentrated by service line. That concentration creates sensitivity to Medicaid reimbursement changes or policy shifts affecting office E/M and point-of-care testing reimbursement, as the bulk of lifetime revenue is tied to those categories.

Medicaid: Complete Services Breakdown

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

80 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…	192,020	$80	$15M
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…	201,430	$60	$12.3M
99203	The provider sees a new 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 provider…	114,070	$70	$8.4M
S9088	Services provided in an urgent care center (list in addition to code for service)	142,700	$20	$2.6M
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…	20,510	$100	$2.1M
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	81,010	$30	$2.1M
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	155,780	$10	$1.9M
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.	106,210	$10	$1.3M
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	34,280	$30	$1M
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	10,430	$60	$573.6K

Showing 1–10 of 80

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Medexpress Urgent Care, PC - Virginia — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

80 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	4	20	150	$100	$1.5M
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…	10	3,520	370	$70	$280.7K
S9088	Services provided in an urgent care center (list in addition to code for service)	2	20	850	$10	$270.1K
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…	6	4,010	290	$50	$199.8K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	35	210	390	$50	$106.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	122	610	150	$90	$104K
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…	8	970	100	$100	$87.1K
99203	The provider sees a new 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 provider…	1	1,000	100	$70	$81.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	483	630	110	$80	$78.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	35	980	140	$70	$70.9K

Showing 1–10 of 80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Dietz	VA	Internal Medicine Physician	$48.8K	$0
Albert Jabbour	FL	Medical Physician Assistant	$8.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ashutosh Chandel	VA	Cardiovascular Disease Physician	$252.3K	$442.1K
David Tolliver	VA	Dermatology Physician	$601K	$30.3K
Mohammad Rana	VA	Cardiovascular Disease Physician	$307.2K	$0
Syed Ahmad	VA	Specialist	$67.7K	$226.6K
Chad Caskey	VA	Physician Assistant	$245.7K	$0
April Neely	VA	Family Nurse Practitioner	$158.7K	$0
Derek Buck	VA	Physical Medicine & Rehabilitation Physician	$71.2K	$0
Katherine Keener	VA	Speech-Language Pathologist	$68.9K	$0
Alfred Dyer	VA	Physical Therapist	$28.7K	$0
Trena Hodges	VA	Family Nurse Practitioner	$25.2K	$0

Medexpress Urgent Care, PC - Virginia — Billing Profile & Reimbursement Data

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Medexpress Urgent Care, PC - Virginia — 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