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.

Community Medical Associates, Inc. (NPI 1306983762)

Key Findings

Field	Value
Entity Type	Organization
Organization	Community Medical Associates, Inc.
Address	4803 Olympia Park Plz Ste 1100
City	Louisville
State	KY
ZIP	40241
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	February 1, 2007

Payer Source	Total Paid
Medicaid	$49M
Medicare	$0

COMMUNITY MEDICAL ASSOCIATES, INC. reports $49M in lifetime Medicaid revenue and has no Medicare billing on file, making its commercial public-pay mix effectively single-payer (Medicaid) in the available data; the provider’s NPI was enumerated 2007-02-01 (~19 years ago), indicating a long-tenured operation in the market.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 87.2% of the provider’s total Medicaid revenue, with three codes — 87636, 99214, and 99213 — driving the vast majority of receipts.

The top revenue driver is 87636 (multiplex NAAT for SARS–CoV–2, influenza A/B): 162.1K claims, $109 avg paid/claim, $17.7M revenue (36.1% of total Medicaid revenue); the provider ranks #1 of 68 statewide and is described as an extreme outlier and far above typical state volume, indicating a centralized high-volume respiratory molecular testing capability.

High volumes of office evaluation-and-management visits are a core service line: 99214 shows 252.9K claims, $61 avg paid/claim, $15.4M revenue (31.5% of total Medicaid revenue) and ranks #8 of 2462 providers in-state (100th percentile; extreme outlier), while 99213 shows 224K claims, $43 avg paid/claim, $9.6M revenue (19.7% of total Medicaid revenue) and ranks #18 of 3339 providers in-state (99th percentile). Together these clinical visit codes imply the organization operates as a high-throughput multi-specialty outpatient clinic with heavy reliance on routine office encounters.

Laboratory and point-of-care testing beyond multiplex respiratory NAAT also contribute meaningfully to service mix: 87651 (Strep A NAAT) generated $3.1M (6.4% of Medicaid revenue) with 125.3K claims and ranks #1 of 197 providers (100th percentile; extreme outlier), and 81003 (urine dipstick automated read) shows 39.7K claims and $39.7K revenue while ranking #5 of 445 providers (99th percentile). These volumes point to integrated specimen collection and lab reporting workflows supporting primary care throughput.

Statewide competitive standing is dominant for several Medicaid codes: the provider is a top-ranked outlier for 87636 and 87651 (both #1 statewide) and for high-acuity office visits (99214 at #8 statewide), indicating market leadership in respiratory molecular testing and large-scale outpatient visit capacity compared with in-state peers.

Operational and payer-risk implications follow from the concentration: with 87.2% of Medicaid revenue coming from three codes and no Medicare billing on file, the provider’s financial performance appears highly sensitive to Medicaid reimbursement policies and utilization shifts for respiratory testing and standard office visits.

Secondary codes and lower-dollar services (e.g., 87502, 87811, 87880, 36415) are present but make up small shares of revenue relative to the top three, which suggests the organization focuses on high-volume diagnostic testing and E/M visits rather than specialty or high-complexity procedural revenue streams.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	162,110	$110	$17.7M
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…	252,860	$60	$15.4M
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…	223,950	$40	$9.6M
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	125,280	$30	$3.1M
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…	25,480	$70	$1.7M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	12,990	$30	$428.7K
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…	3,800	$80	$318.9K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	5,310	$40	$223.1K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	840	$90	$78.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	970	$70	$67.6K

Showing 1–10 of 46

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

Community Medical Associates, Inc. — 8 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

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	1	70	310	$100	$495.2K
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…	18	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…	8	2,460	580	$40	$245K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	29	60	530	$100	$234.4K
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…	165	330	1,400	$30	$156.7K
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…	224	310	3,500	$10	$149.9K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	4	190	360	$60	$119.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	1	200	1,020	$30	$98.2K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	75	170	590	$40	$84.8K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	177	250	1,080	$40	$82.9K

Showing 1–10 of 46

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Medical Associates, Inc.	KY	Internal Medicine Physician	$0	$135.1M
Norton Hospitals Inc	KY	Multi-Specialty Clinic/Center	$0	$3.4M
Patricia Hansen	KY	Internal Medicine Physician	$2.6M	$0
Roneka Ravenell	IN	Rheumatology Physician	$1.3M	$0
Jennifer Teeter	IN	Sports Medicine (Family Medicine) Physician	$1.2M	$0
Topeka Physician Group, LLC	KS	Internal Medicine Physician	$0	$963.7K
Robin Curry	KY	Sports Medicine (Family Medicine) Physician	$628.2K	$0
John Fleming	CA	Orthopaedic Surgery of the Spine Physician	$618.3K	$0
Christopher Graves	IL	Orthopaedic Surgery of the Spine Physician	$533.3K	$83K
Brandon Cook	FL	Orthopaedic Surgery Physician	$572.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton Childrens Medical Group, LLC	KY	Pediatrics Physician	$0	$107.3M
Motc - Louisville LLC	KY	Prosthetic/Orthotic Supplier	$0	$5.4M
Gml Pain Md Psc	KY	Durable Medical Equipment & Medical Supplies	$0	$3.9M
Jacob Yunker	KY	Ophthalmology Physician	$3.8M	$0
Thomas Harper	KY	Ophthalmology Physician	$3.3M	$0
Aspire Case Management LLC	KY	Case Management Agency	$0	$3.2M
Victor Neamtu	KY	Ophthalmology Physician	$1.5M	$980
Michael Mccall	KY	Dermatology Physician	$938.6K	$0
Timothy Brown	KY	Dermatology Physician	$874.6K	$0
Mark Haeberle	KY	Dermatology Physician	$651.4K	$23K

Community Medical Associates, Inc. — Billing Profile & Reimbursement Data

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Community Medical Associates, Inc. — Billing Profile & Reimbursement Data

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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