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

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

Primary Care Partners, Inc. (NPI 1245392612)

Primary Care Partners, Inc. is a family medicine physician provider located in Grand Junction, Colorado. This profile covers 0 Medicare and 95 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	Primary Care Partners, Inc.
Address	3150 N 12th St
City	Grand Junction
State	CO
ZIP	81506
Taxonomy	Family Medicine Physician
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicaid	$17.1M
Medicare	$0

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

95 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…	100,670	$60	$6M
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…	64,620	$80	$5.4M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	20,630	$40	$845.9K
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…	6,500	$90	$565.2K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	3,910	$140	$540.1K
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…	5,870	$90	$504.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,050	$90	$454.2K
S9088	Services provided in an urgent care center (list in addition to code for service)	7,650	$50	$382.7K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	8,490	$30	$271.7K
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…	14,210	$20	$255.7K

Showing 1–10 of 95

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Primary Care Partners, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

95 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…	11	2,520	330	$100	$352K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	114	310	1,750	$40	$319.9K
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	2,630	430	$90	$268.2K
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…	569	1,670	550	$100	$229.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	165	680	1,160	$50	$223.5K
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…	23	240	550	$110	$208.5K
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…	17	260	380	$100	$161.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	110	180	1,040	$10	$127.6K
90834	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…	137	590	200	$80	$119.9K
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,…	95	690	140	$90	$118.4K

Showing 1–10 of 95

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Johnathan Hays	VA	Diagnostic Radiology Physician	$275K	$32K
Daniel Sullivan	CO	Family Medicine Physician	$215.4K	$0
Andrew Mohler	CO	Family Medicine Physician	$186.9K	$0
Thomas Cate	CO	Internal Medicine Physician	$148K	$7.1K
John Flanagan	CO	Family Medicine Physician	$134.7K	$0
Conor Senecal	WA	Cardiovascular Disease Physician	$122.9K	$0
Raminder Dhillon-acosta	CO	Diagnostic Radiology Physician	$120.4K	$0
Lynn Price	CO	Family Medicine Physician	$117.1K	$0
Craig Hughes	CO	Family Medicine Physician	$108.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Premier Healthcare Services, LLC	CO	In Home Supportive Care Agency	$0	$82.8M
Summitwest Care	CO	In Home Supportive Care Agency	$0	$15.1M
A Better Life Experience Inc.	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$13.8M
Home Care Of Grand Junction LLC	CO	In Home Supportive Care Agency	$0	$13.2M
Summitwest Care	CO	Home Health Agency	$0	$12.3M
Triumph Properties, LLC	CO	Assisted Living Facility	$0	$11.7M
Rocky Mountain Health Maintenance Organization, Inc	CO	Case Management Agency	$0	$9.1M
Premier Healthcare Services, LLC	CO	Home Health Agency	$0	$8.7M
Evolve Behavioral Services, LLC	CO	Behavior Analyst	$0	$3.8M
John Moore	CO	Clinical Cardiac Electrophysiology Physician	$248.2K	$530

Primary Care Partners, Inc. — Billing Profile & Reimbursement Data

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Primary Care Partners, Inc. — 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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