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

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

Orthowest LLC (NPI 1275641904)

Orthowest LLC is a orthopaedic surgery physician provider located in Omaha, Nebraska. This profile covers 0 Medicare and 18 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	Orthowest LLC
Address	2725 South 144th Street
City	Omaha
State	NE
ZIP	68144
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	August 25, 2006

Payer Source	Total Paid
Medicaid	$237.3K
Medicare	$0

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

18 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…	2,400	$30	$67.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	1,610	$30	$53.1K
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…	710	$50	$38.5K
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…	480	$50	$23.7K
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…	200	$70	$14.1K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	950	$10	$11.4K
J1040	Injection, methylprednisolone acetate, 80 mg	1,250	$10	$10K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	410	$20	$8.6K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	300	$20	$4.9K
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,…	150	$20	$2.7K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Orthowest LLC — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

18 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…	213	700	660	$70	$305.1K
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…	326	600	610	$70	$251.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	121	210	660	$40	$122.6K
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…	44	190	130	$70	$48.5K
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…	57	130	130	$90	$43.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	3	20	70	$70	$36.7K
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,…	121	250	140	$60	$29.7K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	15	40	590	$20	$27.3K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	31	40	180	$20	$14.8K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	10	20	140	$20	$13.6K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brooke Wagner	NE	Physician Assistant	$478K	$0
Joshua Urban	NE	Orthopaedic Surgery Physician	$289.5K	$0
Sayfe Jassim	NE	Orthopaedic Surgery Physician	$284.7K	$0
Craig Hansen	IA	Orthopaedic Surgery Physician	$282.3K	$0
Ajoy Jana	NE	Orthopaedic Surgery Physician	$252.9K	$0
Mark Goebel	NE	Orthopaedic Surgery Physician	$242.8K	$0
Kirk Hutton	NE	Orthopaedic Surgery Physician	$193.7K	$0
Matthew Hahn	NE	Physical Medicine & Rehabilitation Physician	$182.8K	$0
Andrew Huff	IA	Anesthesiology Physician	$179.3K	$0
Andrew Stanislav	IA	Podiatrist	$169.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Radiology Consultants PC	NE	Diagnostic Radiology Physician	$0	$10M
Omaha Insomnia And Psychiatric Services, LLC	NE	Psychiatry Physician	$0	$1.9M
Becker Counseling Services LLC	NE	Mental Health Counselor	$0	$1.3M
Summit Dental Health - Oakview, LLC	NE	General Practice Dentistry	$0	$1.2M
Elite Professionals Home Care LLC	NE	Home Health Agency	$0	$1.1M
Shoptikal LLC	NE	Eyewear Supplier	$0	$987.5K
Pedodontics, PC	NE	Pediatric Dentistry	$0	$839.9K
Nebraska Home Health - Opco LLC	NE	Home Health Agency	$0	$828K
Nebraska Orthopaedic Hospital LLC	NE	General Acute Care Hospital	$0	$787.6K
Diamond Chiropractic & Acupuncture, LLC	NE	Chiropractor	$0	$684.7K

Orthowest LLC — Billing Profile & Reimbursement Data

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Orthowest 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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