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

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

Somc Medical Care Foundation, Inc. (NPI 1457467227)

Somc Medical Care Foundation, Inc. is a family medicine physician provider located in Portsmouth, Ohio. This profile covers 0 Medicare and 212 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	Somc Medical Care Foundation, Inc.
Address	1805 27th St
City	Portsmouth
State	OH
ZIP	45662
Taxonomy	Family Medicine Physician
NPI Enumerated	August 22, 2006

Payer Source	Total Paid
Medicaid	$25.3M
Medicare	$0

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

212 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…	335,020	$30	$10.1M
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…	368,880	$20	$8.1M
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…	23,600	$20	$542.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,530	$40	$442.3K
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…	15,130	$30	$408.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	66,930	$10	$401.6K
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…	29,970	$10	$389.6K
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…	10,070	$30	$342.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	10,700	$30	$331.5K
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…	7,020	$50	$329.8K

Showing 1–10 of 212

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Somc Medical Care Foundation, Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

212 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	56	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	36	60	250	$730	$707.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	233	290	1,380	$90	$635.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	227	280	1,110	$110	$605.7K
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…	550	2,640	620	$90	$408.2K
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	4,510	500	$60	$377.8K
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…	11	5,080	560	$40	$323.9K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	193	230	980	$110	$319.6K
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…	24	430	560	$60	$303.2K
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…	35	480	450	$70	$292.9K

Showing 1–10 of 212

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Kentucky	KY	General Acute Care Hospital	$0	$716.8M
Charleston Area Medical Center Inc	WV	General Acute Care Hospital	$0	$200.1M
Wake Forest University Health Sciences	NC	Multi-Specialty Clinic/Center	$0	$188.2M
Pikeville Medical Center Inc	KY	General Acute Care Hospital	$0	$181.5M
William Beaumont Hospital	MI	Hospitalist Physician	$0	$167.9M
Oakwood Healthcare, Inc.	MI	General Acute Care Hospital	$0	$165.3M
William Beaumont Hospital	MI	General Acute Care Hospital	$0	$162.4M
Kentucky Medical Services Foundation, Inc	KY	Internal Medicine Physician	$0	$110.4M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$107.9M
Michigan Healthcare Professionals PC	MI	Internal Medicine Physician	$0	$106.2M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scioto County Counseling Center, Inc	OH	Addiction (Substance Use Disorder) Counselor	$0	$166.5M
Southern Ohio Medical Center	OH	General Acute Care Hospital	$0	$144.9M
Phoenix Group Home, LLC	OH	Community/Behavioral Health Agency	$0	$98.8M
Mahajan Therapeutics, LLC	OH	Community/Behavioral Health Agency	$0	$33.9M
Scioto County Counseling Center, Inc.	OH	Mental Health Counselor	$0	$27.7M
Amazing Grace Center Inc	OH	Methadone Clinic	$349.1K	$26.2M
Portsmouth Emergency Ambulance Service Inc	OH	Ambulance	$3.6M	$18.7M
Genesis Respiratory Services Inc	OH	Durable Medical Equipment & Medical Supplies	$0	$20.4M
Portsmouth Hospital Corporation	OH	General Acute Care Hospital	$0	$19.7M
Jay Hash LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$19.1M

Somc Medical Care Foundation, Inc. — Billing Profile & Reimbursement Data

Sign up for Somc Medical Care Foundation, Inc. — Billing Profile & Reimbursement Data policy alerts

Somc Medical Care Foundation, Inc. — Billing Profile & Reimbursement Data

Sign up for Somc Medical Care Foundation, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References