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

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

Lexington Urgent Care PLLC (NPI 1225374887)

Lexington Urgent Care PLLC is a urgent care clinic/center provider located in Lexington, Kentucky. This profile covers 0 Medicare and 48 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	Lexington Urgent Care PLLC
Address	1701 Nicholasville Rd
City	Lexington
State	KY
ZIP	40503
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	December 28, 2012

Payer Source	Total Paid
Medicaid	$16.7M
Medicare	$0

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

48 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…	113,340	$40	$4.3M
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	91,700	$40	$3.2M
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…	37,180	$70	$2.5M
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…	37,650	$60	$2.2M
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.	141,990	$10	$1.7M
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.	56,240	$10	$674.9K
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,…	17,190	$30	$464K
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…	9,950	$40	$437.6K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	9,450	$40	$340K
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,…	11,020	$20	$242.5K

Showing 1–10 of 48

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Lexington Urgent Care PLLC — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	39	3,340	1,020	$30	$296K
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	2,460	580	$40	$245K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	219	330	1,400	$30	$156.7K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	1	90	590	$30	$127K
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…	67	170	590	$40	$84.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	288	320	180	$70	$79.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	8	210	230	$40	$79.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	251	540	210	$20	$78.3K
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	42	40	90	$130	$67.5K
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…	73	1,020	120	$70	$62K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abdolreza Rabiee	KY	Emergency Medicine Physician	$377.4K	$0
Eyad Alhaj	IL	Interventional Cardiology Physician	$203.5K	$1K
Nawar Soda	KY	Family Medicine Physician	$132.3K	$2.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Encore Adhc, LLC	KY	Adult Day Care Clinic/Center	$0	$51.9M
Center For Comprehensive Services, Inc	KY	Rehabilitation Hospital	$0	$28.7M
Lhcg Lxx, LLC	KY	Home Health Agency	$0	$27.1M
P & C Labs, LLC	KY	Clinical Medical Laboratory	$427.3K	$18M
Healthfirst Bluegrass Inc	KY	Federally Qualified Health Center (FQHC)	$0	$18.1M
Ndt Care Services, LLC	KY	Community/Behavioral Health Agency	$0	$17.5M
Ballard Wright, Md, Psc	KY	Interventional Pain Medicine Physician	$0	$12.4M
Big Smiles Kentucky Psc	KY	Dentist	$0	$12.3M
Baptist-physicians Surgery Center	KY	Ambulatory Surgical Clinic/Center	$1.3M	$5.8M

Lexington Urgent Care PLLC — Billing Profile & Reimbursement Data

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Lexington Urgent Care PLLC — 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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