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

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

Medcare Express LLC (NPI 1316124548)

Medcare Express LLC is a urgent care clinic/center provider located in Newington, Connecticut. This profile covers 0 Medicare and 39 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	Medcare Express LLC
Address	2288 Berlin Turnpike
City	Newington
State	CT
ZIP	06111
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	January 30, 2008

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

39 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…	33,330	$90	$2.9M
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…	26,490	$60	$1.6M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	21,870	$50	$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…	9,420	$90	$867K
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…	4,670	$70	$317.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	5,820	$40	$233K
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.	6,600	$20	$118.8K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	800	$120	$94.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	810	$110	$89.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	5,680	$10	$62.5K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Medcare Express LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	50	1,590	740	$50	$331.8K
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…	88	1,710	750	$30	$243.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6	140	780	$40	$163.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	146	180	710	$70	$151.2K
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…	17	480	200	$60	$112.1K
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…	384	480	150	$90	$100.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	95	170	410	$70	$98K
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…	77	200	530	$20	$69.3K
G0481	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…	11	10	670	$30	$60.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	32	150	190	$50	$43.5K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hudson Home Health Care Inc	CT	Durable Medical Equipment & Medical Supplies	$0	$41.7M
Edward Cos	CT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.1M
Kci Usa, Inc.	CT	Durable Medical Equipment & Medical Supplies	$0	$1.8M
Myeyedr Optometry Of Connecticut, LLC	CT	Optometrist	$0	$1.4M
Total Vision-eye Health Center LLC	CT	Optometrist	$0	$1.3M
The Gemini Project, LLC	CT	Community/Behavioral Health Agency	$0	$1.2M
Camellia Place Healthcare Services LLC	CT	Primary Care Clinic/Center	$0	$1.1M
Janis Nicholson	CT	Psychiatric/Mental Health Nurse Practitioner	$34.6K	$190.7K
Jennifer Pupek	CT	Family Nurse Practitioner	$127.7K	$0
Craig Kaufman	CT	Podiatrist	$114.9K	$0

Medcare Express LLC — Billing Profile & Reimbursement Data

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Medcare Express LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References