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

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

Optumcare Colorado Medical Group LLC (NPI 1407252828)

Optumcare Colorado Medical Group LLC is a general practice physician provider located in Colorado Springs, Colorado. This profile covers 0 Medicare and 111 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	Optumcare Colorado Medical Group LLC
Address	1633 Medical Center Pt
City	Colorado Springs
State	CO
ZIP	80907
Taxonomy	General Practice Physician
NPI Enumerated	November 12, 2014

Payer Source	Total Paid
Medicaid	$8.8M
Medicare	$0

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

111 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…	53,200	$50	$2.7M
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…	37,460	$60	$2.4M
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.	14,440	$40	$592.1K
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…	5,410	$80	$416.8K
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…	4,600	$90	$413.6K
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…	4,790	$70	$354.3K
J0585	Injection, onabotulinumtoxina, 1 unit	530	$410	$218.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,950	$90	$173.3K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	11,380	$10	$147.9K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	930	$120	$113.1K

Showing 1–10 of 111

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Optumcare Colorado Medical Group LLC — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

111 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	20	50	340	$520	$452.1K
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…	33	2,520	330	$100	$352K
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…	31	2,630	430	$90	$268.2K
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…	1,363	1,670	550	$100	$229.3K
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…	26	240	550	$110	$208.5K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	16	30	150	$320	$193.1K
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…	77	130	670	$50	$192.3K
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…	66	220	340	$60	$188.2K
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…	26	260	380	$100	$161.6K
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.	33	110	170	$180	$126.2K

Showing 1–10 of 111

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Perkins	CO	Rheumatology Physician	$678.2K	$0
Daniel Erhardt	CO	Rheumatology Physician	$547.9K	$0
Nicole Swavely	CO	Rheumatology Physician	$379.8K	$0
Prateek Chaudhary	CO	Rheumatology Physician	$330K	$0
James Haug	CO	Diagnostic Radiology Physician	$326.9K	$0
Optumcare Colorado Medical Group, LLC	CO	Clinical Medical Laboratory	$315K	$0
Robert Schreiner	CO	Rheumatology Physician	$303.9K	$0
Jill Gibson	CO	Rheumatology Physician	$303.3K	$0
Hazem Ubaissi	CO	Pulmonary Disease Physician	$200.2K	$0
Carson Maynard	CO	Rheumatology Physician	$189.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Physicians Home Care	CO	In Home Supportive Care Agency	$0	$247.9M
A Circle Of Care Colorado, LLC.	CO	In Home Supportive Care Agency	$0	$101.8M
Goodwill Of Colorado	CO	Home Health Agency	$0	$33.3M
Stellar Care And Services, LLC	CO	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$31M
Catholic Health Initiatives Colorado	CO	General Acute Care Hospital	$0	$25.2M
American Medical Response Of Colorado Inc	CO	Ambulance	$3.4M	$21.6M
Special Kids Special Families	CO	Developmentally Disabled Services Day Training Agency	$0	$24.8M
Lucas Inc	CO	Respite Care	$0	$23.6M
Achieve Whole Recovery, PC	CO	Specialist	$0	$22.7M
Loving Care Agency, Inc.	CO	In Home Supportive Care Agency	$0	$18.2M

Optumcare Colorado Medical Group LLC — Billing Profile & Reimbursement Data

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Optumcare Colorado Medical Group LLC — 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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