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

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

Licking Memorial Health Professionals (NPI 1326072265)

Licking Memorial Health Professionals is a family medicine physician provider located in Newark, Ohio. This profile covers 0 Medicare and 190 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	Licking Memorial Health Professionals
Address	1320 W Main St
City	Newark
State	OH
ZIP	43055
Taxonomy	Family Medicine Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$23.9M
Medicare	$0

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

190 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…	219,350	$30	$7.5M
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…	113,750	$50	$5.1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	30,390	$50	$1.6M
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.	87,640	$20	$1.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	40,840	$30	$1.2M
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…	15,970	$60	$926.2K
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…	15,660	$50	$798.6K
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,…	23,560	$20	$424K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,860	$60	$390.7K
J1050	Injection, medroxyprogesterone acetate, 1 mg	4,250	$80	$340K

Showing 1–10 of 190

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Licking Memorial Health Professionals — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

190 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	74	480	4,510	$90	$1.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	102	660	460	$90	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	189	580	510	$100	$1.3M
J0585	Injection, onabotulinumtoxina, 1 unit	44	60	250	$730	$707.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	32	230	2,200	$100	$530.1K
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…	1,067	2,640	620	$90	$408.2K
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…	39	4,510	500	$60	$377.8K
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…	22	5,080	560	$40	$323.9K
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…	22	430	560	$60	$303.2K
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…	20	480	450	$70	$292.9K

Showing 1–10 of 190

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
David Weng	MD	Medical Oncology Physician	$1.5M	$0
John Abboud	CO	Cardiovascular Disease Physician	$190.7K	$0
Laura Schaeffer	OH	Dermatology Physician	$138.5K	$0
Hassan Rajjoub	OH	Interventional Cardiology Physician	$130.8K	$0
J Mcgraw	OH	Vascular & Interventional Radiology Physician	$119.1K	$0
Frank Boateng	OH	Nephrology Physician	$117.8K	$0
Suba Pathmanathan	OH	Internal Medicine Physician	$104.2K	$0
Nathan Kander	OH	Interventional Cardiology Physician	$102.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Licking Memorial Hospital	OH	General Acute Care Hospital	$0	$55.9M
Hospice Of Central Ohio	OH	Community Based Hospice Care Agency	$0	$28M
Behavioral Healthcare Partners Of Central Ohio Inc	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$14M
City Of Newark	OH	Land Ambulance	$505.9K	$2M
Courtesy Ambulance, Inc.	OH	Land Ambulance	$343.3K	$1.8M
Licking County	OH	Public Health or Welfare Agency	$31.4K	$524.4K
Chuck Cho	OH	Radiation Oncology Physician	$314.9K	$0
Thomas Petryk	OH	Family Medicine Physician	$274.7K	$0
Mark Law	OH	Ophthalmology Physician	$258.6K	$490
Shahin Shahinfar	OH	Ophthalmology Physician	$254.9K	$0

Licking Memorial Health Professionals — Billing Profile & Reimbursement Data

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Licking Memorial Health Professionals — 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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