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

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

Monticello Medical Clinic Plc (NPI 1366422305)

Monticello Medical Clinic Plc is a clinic/center provider located in Monticello, Arkansas. This profile covers 0 Medicare and 78 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	Monticello Medical Clinic Plc
Address	906 Roberts Dr
City	Monticello
State	AR
ZIP	71655
Taxonomy	Clinic/Center
NPI Enumerated	January 17, 2006

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

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

78 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…	47,010	$30	$1.4M
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…	3,170	$50	$158.4K
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…	2,670	$50	$122.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	5,650	$10	$62.1K
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,…	1,120	$40	$43.5K
87275	The lab analyst performs a test to detect influenza B virus antigens using methods such as an immunofluorescent antibody stain and fluorescence microscopy.	3,120	$10	$34.3K
87276	The lab analyst performs a test to detect influenza A virus antigens using methods such as an immunofluorescent antibody stain and fluorescence microscopy.	3,120	$10	$34.3K
99219	N/A	670	$50	$33.7K
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,…	1,450	$20	$33.3K
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…	510	$60	$32K

Showing 1–10 of 78

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Monticello Medical Clinic Plc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

78 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	785	1,520	550	$40	$128.7K
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…	37	210	500	$50	$106.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	77	260	430	$30	$93.3K
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…	16	1,740	550	$30	$88.8K
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…	43	250	460	$50	$86.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	88	280	190	$50	$48.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	94	330	680	$10	$48.3K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	9	10	660	$20	$42.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	125	210	250	$50	$39.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	34	140	200	$40	$38.6K

Showing 1–10 of 78

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Timothy Simon	AR	Family Medicine Physician	$416.8K	$0
Joseph Fakouri	AR	Family Medicine Physician	$262.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advantages Of Southeast Arkansas, Inc.	AR	Case Management Agency	$0	$26.4M
Delta Counseling Associates Inc	AR	Community/Behavioral Health Agency	$0	$15M
Living Hope Southeast, LLC	AR	Mental Health Counselor	$0	$13.2M
Bhc Pinnacle Pointe Healthcare	AR	Adolescent and Children Mental Health Clinic/Center	$0	$10M
Mainline Health Systems Inc	AR	Federally Qualified Health Center (FQHC)	$0	$4.8M
Odyssey Healthcare Operating A, LP	AR	Home Health Agency	$0	$4M
Drew Memorial Hospital, Inc.	AR	General Acute Care Hospital	$0	$3.8M
Monticello Ambulance Service Inc.	AR	Land Ambulance	$321.1K	$577.4K
Southeast Emergency Medical Service, Inc	AR	Ambulance	$286K	$520.6K
Scott Claycomb	AR	Ophthalmology Physician	$786.7K	$0

Monticello Medical Clinic Plc — Billing Profile & Reimbursement Data

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Monticello Medical Clinic Plc — 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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