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

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

Adena Medical Group LLC (NPI 1235468083)

Adena Medical Group LLC is a family medicine physician provider located in Chillicothe, Ohio. This profile covers 0 Medicare and 261 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	Adena Medical Group LLC
Address	272 Hospital Rd
City	Chillicothe
State	OH
ZIP	45601
Taxonomy	Family Medicine Physician
NPI Enumerated	December 8, 2009

Payer Source	Total Paid
Medicaid	$39.9M
Medicare	$0

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

261 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…	483,500	$30	$14.5M
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…	356,620	$40	$13.6M
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…	26,160	$50	$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…	25,410	$40	$965.5K
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…	23,100	$30	$762.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	15,520	$50	$698.5K
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…	19,940	$40	$697.9K
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…	15,340	$40	$613.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	71,740	$10	$430.4K
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.	33,740	$10	$371.1K

Showing 1–10 of 261

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Adena Medical Group LLC — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

261 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9654	Monitored anesthesia care (mac)	5	10	70	$1,000	$3.1M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	57	80	100	$860	$719.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,046	2,640	620	$90	$408.2K
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…	8	4,510	500	$60	$377.8K
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…	9	5,080	560	$40	$323.9K
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…	15	430	560	$60	$303.2K
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…	22	480	450	$70	$292.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	25	280	570	$250	$276.5K
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…	180	270	420	$90	$276K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	20	40	330	$250	$273.7K

Showing 1–10 of 261

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nationwide Children's Hospital	OH	General Acute Care Hospital	$0	$777.8M
Adena Health System	OH	General Acute Care Hospital	$0	$98M
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Pediatric Academic Association, Inc.	OH	Pediatrics Physician	$0	$37.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Marion Area Physicians LLC	OH	Internal Medicine Physician	$0	$15.7M
Rahul Kar	OH	Vascular Surgery Physician	$2M	$0
Five Rivers Medical Center Inc.	AR	General Acute Care Hospital	$0	$2M
Sayuri Cheruvu	IN	Medical Oncology Physician	$934.1K	$0
Ki Hassler	FL	Cardiovascular Disease Physician	$858.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scioto Paint Valley Mental Health Center	OH	Multi-Specialty Clinic/Center	$0	$17.4M
Wise Medical Staffing, Inc.	OH	Home Health Agency	$0	$12.8M
Scioto Paint Valley Mh Ctr	OH	Multi-Specialty Clinic/Center	$0	$9.5M
National Church Residences At Home Hospice	OH	Community Based Hospice Care Agency	$0	$8.9M
Safe Haven Darts,llc	OH	Case Management Agency	$0	$8.2M
Family Urgent Care, LLC.	OH	Urgent Care Clinic/Center	$0	$7.9M
Pinnacle Treatment Centers Oh-ii, LLC	OH	Methadone Clinic	$145.6K	$7.1M
Ross County Home Health LLC	OH	Home Health Agency	$0	$7M
City Of Chillicothe	OH	Land Ambulance	$324K	$1.5M
Michael Chester	OH	Optometrist	$91.5K	$778.6K

Adena Medical Group LLC — 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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