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.

Summit Primary Care (NPI 1285256818)

Summit Primary Care is a family medicine physician provider located in Colorado Springs, Colorado. This profile covers 0 Medicare and 139 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	Summit Primary Care
Address	75 Printers Pkwy
City	Colorado Springs
State	CO
ZIP	80910
Taxonomy	Family Medicine Physician
NPI Enumerated	May 18, 2020

Payer Source	Total Paid
Medicaid	$10.3M
Medicare	$0

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

139 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	20,410	$180	$3.8M
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…	28,220	$70	$1.8M
82075	The lab analyst performs the technical lab test to analyze the quantitative amount of alcohol in a patient’s breath and correlates the measurement to blood alcohol content.	21,410	$20	$385.3K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	33,830	$10	$304.5K
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…	6,050	$50	$290.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	19,110	$20	$286.6K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	210	$820	$170.6K
83992	The lab analyst measures the level of this drug, phencyclidine, typically in a urine or blood sample. This very potent street drug is a common drug of abuse.	5,740	$20	$103.3K
80329	The lab analyst measures the amount of or detects the presence of one or two nonopioid analgesics, which are pain medications, in the patient specimen.	5,740	$20	$91.8K
80332	The lab analyst measures the amount of or detects the presence of one or two serotonergic antidepressants, which are psychiatric medications, in a patient specimen.	5,740	$20	$91.8K

Showing 1–10 of 139

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

Summit Primary Care — 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

139 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	40	900	$170	$1.5M
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…	290	2,520	330	$100	$352K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	14	40	110	$160	$326K
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…	49	2,630	430	$90	$268.2K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	33	60	360	$30	$183.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	38	70	350	$30	$150K
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.	138	180	1,040	$10	$127.6K
80357	The lab analyst measures the amount of or detects the presence of ketamine and norketamine in the patient specimen.	4	10	3,570	$20	$122.5K
87640	The lab analyst performs the technical lab test to look for Staphylococcus aureus nucleic acid using an amplified probe technique.	5	10	100	$30	$122.2K
80360	The lab analyst measures the amount of or detects the presence of methylphenidate, which is a central nervous system stimulant that treats attention deficit disorders, in the patient specimen.	4	10	3,630	$20	$119.4K

Showing 1–10 of 139

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Richard White	CO	Physician Assistant	$95.7K	$0
Melissa Young	CO	Family Nurse Practitioner	$93.5K	$0
Lawrence Wilner	TX	Family Medicine Physician	$84.1K	$0
Callie Davidson	CO	Family Nurse Practitioner	$66.4K	$0
Emily Garcia	TX	Family Nurse Practitioner	$65.1K	$0
Samantha Pushchak	CO	Physician Assistant	$61.3K	$0
Shannon Graves	CO	Psychiatric/Mental Health Nurse Practitioner	$60.7K	$0
Cynthia Bairn	CO	Family Nurse Practitioner	$41K	$0
Taryne Wolf	CO	Nurse Practitioner	$36.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$37.8M
Kaaum Enterprises	CO	Developmental Disabilities Clinic/Center	$0	$34.3M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$28.6M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$19.9M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$12.4M
Diversus Health Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.2M
Diversus Health Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.5M
Your Choice Residential	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.5M
Kids Crossing	CO	Voluntary or Charitable Agency	$0	$8M
Diversus Health Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.8M

Summit Primary Care — Billing Profile & Reimbursement Data

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Summit Primary Care — 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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