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

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

Positive Recovery Solutions, LLC (NPI 1235564188)

Positive Recovery Solutions, LLC is a general practice physician provider located in Washington, Pennsylvania. 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	Positive Recovery Solutions, LLC
Address	378 W Chestnut St Ste 103
City	Washington
State	PA
ZIP	15301
Taxonomy	General Practice Physician
NPI Enumerated	September 11, 2013

Payer Source	Total Paid
Medicaid	$29.2M
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
J2315	Injection, naltrexone, depot form, 1 mg	26,880	$1,020	$27.3M
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…	6,130	$60	$343.3K
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…	8,470	$40	$296.4K
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…	3,620	$80	$289.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	23,510	$10	$282.1K
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…	4,310	$50	$232.8K
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…	26,530	$10	$212.3K
Q3014	Telehealth originating site facility fee	14,190	$10	$113.5K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	12,340	$10	$61.7K
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.	3,500	$10	$42K

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Positive Recovery Solutions, LLC — 9 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2315	Injection, naltrexone, depot form, 1 mg	1	10	3,300	$950	$8M
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.	172	980	310	$50	$136.6K
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…	294	8,160	210	$60	$68.4K
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…	303	8,870	240	$40	$56.1K
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…	17	1,410	60	$90	$30.5K
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…	30	1,620	80	$60	$28.4K
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,…	1,006	1,630	90	$30	$22K
Q3014	Telehealth originating site facility fee	3	70	290	$10	$20.9K
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…	2	310	280	$10	$18.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1	640	180	$10	$8.9K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scott Cook	PA	Family Medicine Physician	$130.6K	$3.9M
David Hevert	FL	Internal Medicine Physician	$587.5K	$0
William Fannin	KY	Addiction Medicine (Internal Medicine) Physician	$16.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Care Center	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$19.5M
Phoenix-washington, Inc. - Tdba Greenbriar Treatment Center	PA	Substance Abuse Rehabilitation Facility	$0	$17.4M
Gateway Rehabilitation Center	PA	Substance Use Disorder Rehabilitation Clinic/Center	$0	$14.6M
Trpil Community Services	PA	Home Health Agency	$0	$12.4M
Upmc Washington	PA	General Acute Care Hospital	$0	$11.2M
Ambulance And Chair Ems, Inc	PA	Land Ambulance	$904.2K	$5.6M
Abstinent Living At The Turning Point At Washington, Inc	PA	Addiction (Substance Use Disorder) Counselor	$0	$5.9M
E. Ronald Salvitti, M.d., Inc.	PA	Ambulatory Surgical Clinic/Center	$986.7K	$20.9K
Guy Avolio	PA	Emergency Medicine Physician	$558.1K	$234.2K
Ziad Simon Fawaz	PA	Radiation Oncology Physician	$453.1K	$0

Positive Recovery Solutions, LLC — Billing Profile & Reimbursement Data

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Positive Recovery Solutions, 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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