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

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

Fairview Express Care (NPI 1346722675)

Fairview Express Care is a general practice physician provider located in Saint Paul, Minnesota. This profile covers 0 Medicare and 122 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	Fairview Express Care
Address	1700 University Ave W
City	Saint Paul
State	MN
ZIP	55104
Taxonomy	General Practice Physician
NPI Enumerated	September 4, 2018

Payer Source	Total Paid
Medicaid	$11.4M
Medicare	$0

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

122 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…	32,650	$70	$2.4M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	5,830	$210	$1.2M
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…	25,930	$50	$1.2M
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…	15,190	$60	$957.1K
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…	9,620	$100	$943.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	12,610	$60	$756.4K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	6,480	$100	$635K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	3,920	$110	$423.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	4,670	$90	$397.2K
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…	2,810	$90	$238.6K

Showing 1–10 of 122

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Fairview Express Care — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

122 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	133	160	580	$170	$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.	172	210	980	$140	$1.7M
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.	218	220	1,730	$120	$1.3M
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…	58	1,180	1,150	$80	$605.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	80	100	510	$40	$560.8K
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…	83	1,200	1,030	$70	$549.7K
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…	340	1,140	1,010	$100	$543K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	54	620	560	$80	$361.9K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	19	80	1,070	$90	$341.2K
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.	140	150	500	$110	$293.1K

Showing 1–10 of 122

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Memorial Health Care	MN	Ambulance	$0	$112.8M
Fairview Health Services	MN	General Acute Care Hospital	$0	$90.4M
Fairview Health Services	MN	Land Ambulance	$2.3M	$48.5M
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Fairview Express Care	MN	Specialist	$0	$33.1M
North Memorial Health Care	MN	General Acute Care Hospital	$0	$32.5M
Fairview Health Services	MN	General Acute Care Hospital	$0	$30M
Fairview Health Services	MN	Emergency Medicine Physician	$0	$26.6M
Fairview Health Services	MN	General Acute Care Hospital	$0	$17.2M
University Of Minnesota Health Clinics And Surgery Center, Inc.	MN	Clinic/Center	$0	$16.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Heritage Home Health Care Inc.	MN	Home Health Agency	$0	$66.7M
Amherst H. Wilder Foundation	MN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$33.9M
Allegiance Ability Assistance LLC	MN	Home Health Agency	$0	$25.9M
Pathways Counseling Center, Inc.	MN	Rehabilitation Psychologist	$0	$23.3M
Catholic Charities Of The Archdiocese Of St Paul & Mpls	MN	Case Management Agency	$0	$17.5M
Twin Town Treatment Center LLC	MN	Substance Abuse Rehabilitation Facility	$0	$16.7M
Caremate Home Health Care, Inc.	MN	Home Health Agency	$0	$14.2M
Ea Bilingual Services, Inc.	MN	Interpreter	$0	$12.6M
Transitions Homes Corporation	MN	Substance Abuse Rehabilitation Facility	$0	$11.8M
Asian-american Home Health Care Services, Incorporated	MN	Home Health Agency	$0	$11.4M

Fairview Express Care — Billing Profile & Reimbursement Data

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Fairview Express Care — 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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