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

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

Physicians Primary Care Of Southwest Florida Pl (NPI 1356336705)

Physicians Primary Care Of Southwest Florida Pl is a general practice physician provider located in Fort Myers, Florida. This profile covers 0 Medicare and 51 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	Physicians Primary Care Of Southwest Florida Pl
Address	12730 New Brittany Blvd Ste 200
City	Fort Myers
State	FL
ZIP	33907
Taxonomy	General Practice Physician
NPI Enumerated	September 13, 2005

Payer Source	Total Paid
Medicaid	$14.2M
Medicare	$0

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

51 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…	69,350	$90	$5.9M
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…	18,730	$120	$2.2M
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…	13,680	$130	$1.8M
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…	13,690	$120	$1.7M
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.	27,840	$30	$890.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,550	$110	$616K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	16,230	$20	$276K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	8,300	$30	$232.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,550	$120	$186.2K
99188	The provider applies a fluoride adhesive over the tooth surface to prevent tooth decay, provide remineralization, or treat hypersensitivity.	8,140	$10	$113.9K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Physicians Primary Care Of Southwest Florida Pl — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	24	1,130	780	$90	$210.4K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	637	640	4,400	$10	$193.4K
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…	21	1,050	640	$80	$183.6K
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…	40	5,930	460	$40	$169.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	58	1,120	520	$80	$141.7K
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…	141	6,380	430	$50	$139.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	197	980	360	$80	$97.2K
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…	607	980	120	$90	$76.8K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	83	880	610	$30	$71.7K
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.	32	1,140	1,240	$10	$70.8K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alejandro Martinez	FL	Family Medicine Physician	$187K	$0
Dean Traiger	FL	Family Medicine Physician	$143.3K	$0
Blaise Kovaz	FL	Obstetrics & Gynecology Physician	$72.3K	$0
Karla Noel	HI	Family Medicine Physician	$47.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Resource Network Of Florida, LLC	FL	In Home Supportive Care Agency	$0	$20.4M
Unlimited Home Health Services Corp	FL	Home Health Agency	$0	$14.2M
Community Resource Network Of Florida, LLC	FL	In Home Supportive Care Agency	$0	$13.3M
Eleven Ash Inc	FL	Home Health Agency	$0	$11.7M
Alexander Eaton	FL	Retina Specialist (Ophthalmology) Physician	$9.7M	$0
Pediatric Services Of America, LLC	FL	Nursing Care Agency	$0	$9.5M
Hussein Wafapoor	FL	Retina Specialist (Ophthalmology) Physician	$8.1M	$0
Eye Specialists Laser & Surgery Center Inc	FL	Ophthalmologic Surgery Clinic/Center	$1.9M	$0
Edward Humbert	FL	Adult Reconstructive Orthopaedic Surgery Physician	$1.7M	$0
Heart & Vascular Ambulatory Surgery Center, LLC	FL	Ambulatory Surgical Clinic/Center	$1.6M	$0

Physicians Primary Care Of Southwest Florida Pl — Billing Profile & Reimbursement Data

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Physicians Primary Care Of Southwest Florida Pl — 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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