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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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 Medical Center Inc (NPI 1295716694)

Primary Care Medical Center Inc is a family medicine physician provider located in Murray, Kentucky. This profile covers 0 Medicare and 93 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 Medical Center Inc
Address	1000 S 12th St
City	Murray
State	KY
ZIP	42071
Taxonomy	Family Medicine Physician
NPI Enumerated	November 11, 2005

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

93 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…	51,950	$40	$1.8M
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…	8,930	$50	$473.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	9,690	$20	$164.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	15,910	$10	$143.2K
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…	1,670	$60	$105.3K
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…	1,190	$70	$86K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	5,520	$20	$82.7K
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.	2,830	$30	$82K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	930	$70	$68.7K
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…	4,230	$10	$59.1K

Showing 1–10 of 93

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Primary Care Medical Center Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

93 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…	107	3,340	1,020	$30	$296K
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…	243	2,460	580	$40	$245K
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…	198	470	770	$20	$188.2K
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…	79	230	720	$60	$180.1K
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…	95	260	540	$70	$176.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	45	90	480	$60	$158.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	211	330	1,400	$30	$156.7K
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…	259	290	520	$30	$156.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	77	110	700	$60	$155.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	102	310	3,500	$10	$149.9K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Murray-calloway County Public Hospital Corporation	KY	General Acute Care Hospital	$0	$29.5M
Community Living In Kentucky, LLC	KY	Community/Behavioral Health Agency	$0	$21.3M
Behavior Support Services, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$9.2M
Vmd Primary Providers Central Kentucky	KY	Internal Medicine Physician	$0	$4.4M
Watch, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$3.8M
Murray-calloway County Public Hospital Corporation	KY	Multi-Specialty Clinic/Center	$0	$3.3M
Pamela Smith	KY	Hematology & Oncology Physician	$1.8M	$0
Murray Calloway County Emergency	KY	Land Ambulance	$538.6K	$581.8K
Jesse Williams	KY	Optometrist	$44.4K	$352.5K
James Jaco	KY	Optometrist	$69K	$304.6K

Primary Care Medical Center Inc — Billing Profile & Reimbursement Data

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Primary Care Medical Center 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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