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

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

Integrated Medical Group P C (NPI 1336102268)

Integrated Medical Group P C is a family medicine physician provider located in Pottsville, Pennsylvania. This profile covers 0 Medicare and 95 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	Integrated Medical Group P C
Address	82 Tunnel Rd
City	Pottsville
State	PA
ZIP	17901
Taxonomy	Family Medicine Physician
NPI Enumerated	April 11, 2006

Payer Source	Total Paid
Medicaid	$5.5M
Medicare	$0

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

95 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…	44,150	$40	$1.6M
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…	21,090	$50	$1M
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…	8,160	$90	$734.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,000	$90	$602.1K
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…	6,230	$80	$517.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,100	$90	$443.3K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	830	$70	$58.9K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	810	$60	$50.8K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	3,890	$10	$23.3K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	3,900	$10	$19.5K

Showing 1–10 of 95

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Integrated Medical Group P C — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

95 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	48	60	40	$640	$98K
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.	93	290	90	$290	$85.6K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	56	80	40	$580	$76.9K
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…	18	820	230	$80	$71.7K
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…	52	8,160	210	$60	$68.4K
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…	19	660	180	$70	$63.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	363	550	160	$80	$58.1K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	244	260	690	$10	$57.9K
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…	28	8,870	240	$40	$56.1K
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…	115	610	90	$60	$50.1K

Showing 1–10 of 95

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brent Calhoon	PA	Medical Physician Assistant	$702.8K	$0
Cynthia Lubinsky	PA	Family Medicine Physician	$351.8K	$0
Francis Mohan	PA	Family Medicine Physician	$337.1K	$0
Amrit Narula	PA	Gastroenterology Physician	$294.8K	$0
Manish Mishra	PA	Family Medicine Physician	$276K	$540
Calvin Stoudt	PA	Orthopaedic Surgery Physician	$266.9K	$0
Nathan Tiedeken	PA	Orthopaedic Surgery Physician	$247.9K	$0
Siang Oh	PA	Physical Medicine & Rehabilitation Physician	$246.2K	$0
Kamla Mishra	PA	Internal Medicine Physician	$215.1K	$480
Mark Brayford	PA	Sports Medicine (Family Medicine) Physician	$192.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Redco Group, LLC.	PA	Adolescent and Children Mental Health Clinic/Center	$0	$26.6M
Merakey Pennsylvania	PA	Community/Behavioral Health Agency	$0	$26.3M
The Redco Group, LLC.	PA	Community/Behavioral Health Agency	$0	$16.8M
Lehigh Valley Hospital - Schuylkill	PA	Rural Acute Care Hospital	$0	$6.8M
Pottsville Area Emergency Medical Services, Inc.	PA	Land Ambulance	$931.5K	$2.1M
The Pottsville PA Endoscopy Asc LP	PA	Ambulatory Surgical Clinic/Center	$509.5K	$146.9K
Solomon Luo	PA	Ophthalmology Physician	$390.9K	$31.1K
Schuylkill Open Mri Inc	PA	Radiology Clinic/Center	$365.7K	$9.6K
William Kellogg	PA	Ophthalmology Physician	$108.5K	$245.1K
Progressive Surgical Institute Inc.	PA	Ambulatory Surgical Clinic/Center	$286K	$4.6K

Integrated Medical Group P C — Billing Profile & Reimbursement Data

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Integrated Medical Group P C — 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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