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

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

Physician Groups Lc (NPI 1285664268)

Physician Groups Lc is a multi-specialty clinic/center provider located in Saint Louis, Missouri. This profile covers 0 Medicare and 110 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	Physician Groups Lc
Address	670 Mason Ridge Center Dr Ste 300
City	Saint Louis
State	MO
ZIP	63141
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 4, 2006

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

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

110 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	46,080	$70	$3.2M
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…	44,660	$60	$2.7M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	38,060	$30	$1.2M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,200	$80	$353K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	5,830	$50	$262.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,470	$50	$201.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,700	$40	$199.5K
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…	2,350	$90	$199.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,600	$60	$143.1K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	1,910	$70	$141.6K

Showing 1–10 of 110

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Physician Groups Lc — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

110 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	74	90	120	$250	$141.3K
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…	25	3,170	230	$70	$128.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9	590	260	$40	$120.5K
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…	32	4,310	300	$60	$110.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	105	150	80	$150	$93.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	40	190	270	$70	$91.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	70	80	350	$60	$90.8K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	43	70	300	$110	$81.2K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	21	40	30	$700	$78.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	28	400	160	$50	$78.8K

Showing 1–10 of 110

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Physician Groups Lc	MO	Multi-Specialty Clinic/Center	$0	$4.2M
Ahsan Usman	IL	Hospitalist Physician	$306.9K	$417.5K
Alexander Ryan	IL	Diagnostic Radiology Physician	$128.6K	$564K
Louba Laurie	IL	Diagnostic Radiology Physician	$184.7K	$453.6K
Pramod Menon	LA	Interventional Cardiology Physician	$586.2K	$0
Michael Friedman	IL	Diagnostic Radiology Physician	$145.5K	$436.8K
Chester Harrison	IL	Diagnostic Radiology Physician	$178.2K	$383.2K
Parvish Shah	IL	Diagnostic Radiology Physician	$111.5K	$422.7K
Carolyn Jachna	MO	Endocrinology, Diabetes & Metabolism Physician	$490.8K	$0
Michael Fazio	IL	Diagnostic Radiology Physician	$294.3K	$184.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospitals East Communities	MO	General Acute Care Hospital	$0	$56.5M
Bayada Home Health Care, Inc.	MO	Home Health Agency	$0	$41.2M
Mercy Clinic East Communities	MO	Internal Medicine Physician	$0	$22.2M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$19.8M
Biotech X-ray Inc	MO	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$5.1M	$6M
Western Anesthesiology Associates, Inc.	MO	Anesthesiology Physician	$0	$10.9M
Team Select Home Care Of Missouri, Inc.	MO	Nursing Care Agency	$0	$10.7M
Sensory Solutions, LLC	MO	Occupational Therapist	$0	$7.3M
Excel Home Care, Inc.	MO	Home Health Agency	$0	$6.2M
Independent Home Care, Inc	MO	Homemaker	$0	$5.7M

Physician Groups Lc — Billing Profile & Reimbursement Data

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Physician Groups Lc — 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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