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

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

Edge Medical Care PC (NPI 1447255609)

Edge Medical Care PC is a primary care clinic/center provider located in Riverdale, Maryland. This profile covers 0 Medicare and 37 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	Edge Medical Care PC
Address	5305 Kenilworth Ave
City	Riverdale
State	MD
ZIP	20737
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	June 15, 2005

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

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

37 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…	24,140	$80	$2M
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…	10,420	$110	$1.2M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,510	$120	$290.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,900	$120	$228.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,020	$110	$212.4K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,660	$130	$207.8K
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…	1,000	$110	$107K
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…	480	$100	$47.2K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,910	$20	$43.8K
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,…	940	$50	$42.4K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Edge Medical Care PC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

37 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…	245	3,670	680	$90	$310K
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…	88	3,280	610	$80	$296.1K
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…	144	330	800	$110	$228.7K
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…	173	290	730	$100	$212.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	84	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	45	320	290	$120	$128K
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…	284	730	110	$70	$81.9K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	16	290	140	$120	$62.8K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	118	270	440	$50	$59.8K
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,…	188	900	160	$60	$57.8K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Better Morning	MD	Community/Behavioral Health Agency	$0	$29.3M
Providence Care Inc	MD	Developmental Disabilities Clinic/Center	$0	$12.2M
Riverdale Park Pediatrics PC	MD	Pediatrics Physician	$0	$9.9M
Pediatric Dentistry Of Maryland, LLC	MD	Pediatric Dentistry	$0	$5.7M
Cunping Qiu	MD	General Practice Dentistry	$0	$5.6M
C & A Behaviorial Health Services LLC	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.4M
Sureshkumar Muttath	MD	Internal Medicine Physician	$698.5K	$0
Michael Summerfield	MD	Ophthalmology Physician	$648.3K	$0
Babak Razi	MD	Nephrology Physician	$443.5K	$0
Reva Gill	MD	Internal Medicine Physician	$386.5K	$1K

Edge Medical Care PC — Billing Profile & Reimbursement Data

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Edge Medical Care PC — 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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References