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

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

Summit Medical Group, LLC (NPI 1457802993)

Field	Value
Entity Type	Organization
Organization	Summit Medical Group, LLC
Address	214 E 23rd St
City	Cheyenne
State	WY
ZIP	82001
Taxonomy	Emergency Medicine Physician
NPI Enumerated	October 19, 2016

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

Key Findings

SUMMIT MEDICAL GROUP, LLC has no Medicare billing on file and reports Medicaid revenue of $3.7M, making its current claims footprint effectively single‑payer Medicaid rather than a mixed Medicare/Medicaid practice. This payer concentration shapes how the provider’s financial and utilization profile should be interpreted and compared to peers that bill both programs.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99285, 99284, 99283) account for 100.0% of the provider’s total Medicaid revenue. The three codes are backed by reported revenues of $2.5M (99285), $1M (99284), and $193.8K (99283), and together they fully explain the $3.7M Medicaid total.

The code mix indicates an emergency department operational profile oriented toward high-acuity encounters: 99285 (high level E/M) alone represents $2.5M in revenue with 21.7K claims and an average paid/claim of $113, which is consistent with a heavy volume of complex ED presentations. The next two ED E/M codes, 99284 and 99283, together represent the remaining Medicaid revenue, reinforcing that the service line is predominantly emergency medicine rather than routine outpatient care.

Payment intensity declines with visit complexity: average paid/claim reported is $113 for 99285, $89 for 99284, and $53 for 99283, reflecting standard reimbursement gradients across high, moderate, and low complexity emergency visits. These per‑claim payments combined with the large claim counts (21.7K; 11.7K; 3.7K) drive the revenue concentration toward higher‑acuity billing.

Competitive standing within the state is strongest on the highest‑acuity code: 99285 ranks #2 of 15 providers in‑state and is in the 93th percentile with a label of "notably above typical state volume," indicating the practice is a major statewide participant for high‑acuity ED visits. By contrast, 99284 and 99283 rank #5 of 25 (83th percentile) and #8 of 34 (79th percentile) respectively and are described as typical or unremarkable state volumes, so the provider is less dominant on moderate‑ and low‑complexity ED visits.

Administrative/quality codes appear in the activity mix but do not drive revenue: G9744 shows 195 claims with $0 average paid/claim and $0 revenue, and G8952 shows 13 claims with $0 average paid/claim and $0 revenue. These zero‑paid G‑codes likely reflect measure reporting or eligibility/documentation flags rather than reimbursed services and should be treated as operational/administrative data points rather than revenue sources.

The provider’s NPI was enumerated 2016-10-19 (~10 years ago), indicating a multi‑year presence. This tenure, combined with sustained high volumes on 99285, suggests an established emergency department operation with consistent Medicaid patient flow rather than a recently opened or transient practice.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	21,720	$110	$2.5M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	11,740	$90	$1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	3,660	$50	$193.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	30	$40	$1.1K
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	10	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	200	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Summit Medical Group, LLC — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	5	30	1,430	$110	$429.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2	20	240	$110	$395K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	8	30	610	$90	$246.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	17	20	110	$60	$54.1K
G8952	Elevated or hypertensive blood pressure reading documented, indicated follow-up not documented, reason not given	1	10	10	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	2	10	210	$0	$0

Related Providers

Other providers that share a Tax Identification Number (TIN) with Summit Medical Group, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jared Gamet	WY	Emergency Medicine Physician	$71.3K	$0
Jordan Greer	WY	Emergency Medicine Physician	$59.8K	$0
Natalie Sciano	WY	Emergency Medicine Physician	$55.9K	$0
Ryan Russi-myers	WY	Family Nurse Practitioner	$54.8K	$0
Kurtsy Oswald	WY	Emergency Medicine Physician	$53.6K	$0
Jessica Hughes	WY	Emergency Medicine Physician	$53.1K	$0
James Waters	WY	Emergency Medicine Physician	$47.1K	$0
Russell Lauver	NV	Emergency Medicine Physician	$44.7K	$0
Daniel Surdam	WY	Emergency Medicine Physician	$44.3K	$0
Amy Tortorich	WY	Emergency Medicine Physician	$42.2K	$0

Nearby Providers

Other providers in the same ZIP code as Summit Medical Group, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Magic City Enterprises, Inc	WY	Developmentally Disabled Services Day Training Agency	$0	$23.6M
Cheyenne Habilitation & Therapeutic Center, Inc	WY	Developmentally Disabled Services Day Training Agency	$0	$14.4M
Specialty Counseling & Consulting	WY	Community/Behavioral Health Agency	$0	$8.2M
University Of Wyoming	WY	Federally Qualified Health Center (FQHC)	$0	$5.5M
Cheyenne Regional Physicians Group, LLC	WY	Medical Oncology Physician	$0	$5.1M
Cheyenne Surgical Center LLC	WY	Ambulatory Surgical Clinic/Center	$567.4K	$4.5M
Memorial Hospital Of Laramie County	WY	General Acute Care Hospital	$0	$4M
Goodwill Industries Of Wy, Inc.	WY	Case Management Agency	$0	$3.9M
American Medical Response Ambulance Service Inc	WY	Ambulance	$1.4M	$2.3M
Memorial Hospital Of Laramie County	WY	Home Health Agency	$0	$3.3M

Summit Medical Group, LLC — Billing Profile & Reimbursement Data

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Summit Medical Group, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References