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

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

Medical Foundation, Inc. (NPI 1346654027)

Medical Foundation, Inc. is a geriatric medicine (family medicine) physician provider located in Meridian, Mississippi. This profile covers 0 Medicare and 84 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	Medical Foundation, Inc.
Address	1800 12th St
City	Meridian
State	MS
ZIP	39301
Taxonomy	Geriatric Medicine (Family Medicine) Physician
NPI Enumerated	June 20, 2014

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

84 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…	16,280	$30	$553.5K
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…	4,800	$60	$297.5K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5,810	$30	$162.7K
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…	5,880	$30	$152.9K
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…	2,650	$50	$132.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	490	$130	$65.7K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,220	$50	$64.7K
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…	1,840	$30	$53.5K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	510	$100	$52.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	9,520	$10	$47.6K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Medical Foundation, Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

84 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.	192	220	5,690	$100	$1.2M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	17	30	70	$1,790	$891.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	18	50	300	$510	$483.3K
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.	139	150	2,200	$70	$280.7K
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…	360	1,910	930	$60	$278.7K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	77	120	1,480	$90	$263.1K
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…	41	130	780	$90	$209.6K
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.	41	70	200	$180	$200.4K
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…	63	1,670	720	$50	$196.4K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	21	30	320	$250	$174.1K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unm Hospital	NM	General Acute Care Hospital	$0	$462.9M
Henry Ford Health System	MI	General Acute Care Hospital	$0	$335M
Lsu Health Sciences Center Shreveport Faculty Group Practice	LA	Family Medicine Physician	$0	$235.7M
Inspira Medical Centers, Inc.	NJ	General Acute Care Hospital	$0	$227M
Ochsner Clinic Foundation	LA	General Acute Care Hospital	$0	$166.7M
Ochsner Clinic LLC	LA	General Practice Physician	$0	$152.6M
Wakemed	NC	General Acute Care Hospital	$0	$140.8M
Monterey County Behavioral Health Division	CA	Community/Behavioral Health Agency	$0	$137.8M
Unm Medical Group Inc	NM	Multi-Specialty Clinic/Center	$0	$113.5M
San Joaquin Community Hospital	CA	General Acute Care Hospital	$0	$107.6M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anderson Regional Medical Center	MS	General Acute Care Hospital	$0	$32.5M
Rush Medical Foundation	MS	General Acute Care Hospital	$0	$29.4M
Meridian Pediatric Extended Care LLC	MS	Pediatric Skilled Nursing Facility	$0	$9.3M
Lauderdale County Ems District	MS	Ambulance	$2.1M	$6.4M
Southern Home Private Care LLC	MS	Homemaker	$0	$6M
Kevin Douglas	MS	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.9M
Douglas Orthodontics PLLC	MS	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.7M
Anderson Regional Medical Center	MS	Rural Health Clinic/Center	$0	$5.4M
Laird Hospital, Inc	MS	Rural Health Clinic/Center	$0	$5.3M
Medical Foundation, Inc.	MS	Clinical Medical Laboratory	$1M	$4.2M

Medical Foundation, Inc. — Billing Profile & Reimbursement Data

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Medical Foundation, Inc. — 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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