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.

Regional West Physicians Clinic (NPI 1306910534)

Key Findings

Field	Value
Entity Type	Organization
Organization	Regional West Physicians Clinic
Address	3911 Avenue B Ste 1100
City	Scottsbluff
State	NE
ZIP	69361
Taxonomy	Family Medicine Physician
NPI Enumerated	November 20, 2006

Payer Source	Total Paid
Medicaid	$9M
Medicare	$0

This provider is effectively a Medicaid-focused practice: total Medicaid revenue is $9M while there is no Medicare billing on file (the dataset shows none). The absence of Medicare activity means payer exposure and revenue growth are concentrated almost entirely within Medicaid populations and programs.

Revenue concentration is high: the precomputed top 3 Medicaid codes account for 75.9% of this provider's total Medicaid revenue, driven primarily by two established‑patient office visit codes. Specifically, 99214 generated $3.3M (59.5K claims, $55 avg paid/claim) and 99213 generated $2.6M (59K claims, $44 avg paid/claim), together representing the dominant share of billed Medicaid services.

The code mix and volumes indicate a high-volume primary care / family medicine operation focused on adult chronic and episodic care plus routine preventive services. Heavy utilization of 99214 and 99213 (combined claims volume >118K) alongside preventive visit codes 99391/99392/99394 and vaccine administration codes (90670, 90686, 90647) points to a clinic model that delivers large primary care panels, longitudinal management, well visits, and on-site immunizations.

Competitive standing in-state is particularly strong for core E/M codes: 99214 ranks #7 of 596 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code) and 99213 ranks #8 of 696 providers in-state (99th percentile; notably above typical state volume for this code). These rankings signal the practice is a major regional provider of established outpatient visits and likely captures substantial primary care volume in Scottsbluff and surrounding areas.

While the top E/M codes dominate revenue, the practice also shows above-typical statewide activity in point-of-care testing and ancillary services. Examples include 87428 (2.1K claims, $66.4K revenue; ranks #2 of 35, 97th percentile; notably above typical state volume for this code), 87880 (4K claims, $56.3K revenue; ranks #6 of 129, 96th percentile; notably above typical state volume for this code), and 92557 (1.1K claims, $40.4K revenue; ranks #2 of 19, 94th percentile; notably above typical state volume for this code), indicating substantial on-site lab and diagnostic throughput.

Preventive pediatric services and routine well visits form a consistent secondary revenue stream but at typical volumes for the state. Codes such as 99391 ($659.3K, 8.3K claims; ranks #7 of 69, 91th percentile; typical, unremarkable volume for this code), 99392 ($491K, 5.6K claims), and 99393 ($112.7K, 1.2K claims) together reflect steady investment in periodic preventive care across age groups rather than outlier dominance in pediatrics.

The presence of behavioral health codes (90837, 90834, 90792) and procedures like 76816 (fetal ultrasound) and 43239 (EGD with biopsy) suggests the clinic provides a broader scope of outpatient services beyond routine primary care. While psychiatric and specialty procedure volumes are smaller in revenue share, their inclusion in the top 25 Medicaid codes indicates integrated or co‑located services that expand the clinic’s service line beyond standard family medicine.

This organization has been an established enumerated NPI for a long period (2006-11-20, ~20 years ago), which, coupled with very high Medicaid volumes and multiple top-code outlier rankings, supports the interpretation of a mature, high-capacity regional primary care clinic that serves large Medicaid panels and offers substantial on-site diagnostics and preventive care services.

Medicaid: Complete Services Breakdown

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

97 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…	59,480	$60	$3.3M
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…	59,010	$40	$2.6M
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…	8,350	$80	$659.3K
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…	5,580	$90	$491K
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…	1,650	$120	$201.4K
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…	1,800	$100	$174.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1,390	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,240	$90	$112.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	540	$190	$105.1K
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…	1,890	$50	$102.2K

Showing 1–10 of 97

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

Regional West Physicians Clinic — 4 of 25 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

97 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	6	10	630	$380	$355.1K
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…	8	700	660	$70	$305.1K
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.	9	30	280	$450	$266.7K
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…	7	600	610	$70	$251.4K
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…	13	30	630	$50	$250.1K
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…	7	70	360	$80	$234.7K
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…	9	70	230	$90	$222.7K
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…	14	50	670	$30	$186.5K
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…	121	510	450	$100	$168.1K
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…	95	510	440	$140	$155.7K

Showing 1–10 of 97

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Kabalin	NE	Urology Physician	$453.6K	$0
Thomas Sullivan	NC	Diagnostic Radiology Physician	$18.9K	$393.7K
Mark Hartman	NE	Radiation Oncology Physician	$287.2K	$0
Laroy Williams	NE	Urology Physician	$286.8K	$0
Shanon Smith	NE	Diagnostic Radiology Physician	$275.5K	$0
Jed Hollingsworth	NE	Diagnostic Radiology Physician	$257.2K	$8.1K
Paul Rodriguez	NE	Diagnostic Radiology Physician	$259.9K	$0
Tara Longoria	NE	Family Medicine Physician	$259.8K	$0
Brittany Eirich	NE	Internal Medicine Physician	$248.5K	$0
Serozan Amroliwalla	NE	Internal Medicine Physician	$242.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regional West Medical Center	NE	General Acute Care Hospital	$0	$15.1M
Pediatric Dentistry Of Nebraska	NE	Pediatric Dentistry	$0	$3.6M
Regional West Medical Center	NE	Emergency Medicine Physician	$0	$1.7M
Med-trans Corporation	NE	Air Ambulance	$1.5M	$8.9K
Valley Ambulance Services, Inc	NE	Ambulance	$558K	$868.6K
Regional West Medical Center	NE	Home Health Agency	$0	$1.4M
Options In Psychology LLC	NE	Psychologist	$0	$1.2M
Webb Orthodontics, LLP	NE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.2M
Quick Care Medical Services Inc	NE	Urgent Care Clinic/Center	$0	$1.1M
Renal Treatment Centers West Inc	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.1M

Regional West Physicians Clinic — Billing Profile & Reimbursement Data

Sign up for Regional West Physicians Clinic — Billing Profile & Reimbursement Data policy alerts

Regional West Physicians Clinic — Billing Profile & Reimbursement Data

Sign up for Regional West Physicians Clinic — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References