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

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

Everest Urgent Care (NPI 1497113666)

Field	Value
Entity Type	Organization
Organization	Everest Urgent Care
Address	6787 Market St
City	Upper Darby
State	PA
ZIP	19082
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	February 3, 2016

Payer Source	Total Paid
Medicaid	$17.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9083	Global fee urgent care centers	151,560	$110	$16.8M
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…	6,450	$30	$180.7K
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…	6,100	$30	$176.9K
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…	2,360	$50	$118K
S9088	Services provided in an urgent care center (list in addition to code for service)	6,110	$20	$109.9K
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…	1,220	$80	$98.4K
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,…	2,390	$20	$57.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,120	$30	$33.7K
86580	The lab analyst performs an intradermal skin test on a patient to test for tuberculosis.	640	$50	$29.5K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	2,770	$10	$27.7K

Showing 1–10 of 25

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Everest Urgent Care — 5 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	3	400	360	$110	$571.8K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	623	710	320	$40	$241.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,077	1,280	390	$40	$104.8K
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…	296	8,160	210	$60	$68.4K
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…	404	8,870	240	$40	$56.1K
S9088	Services provided in an urgent care center (list in addition to code for service)	16	500	520	$30	$42.1K
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…	85	1,410	60	$90	$30.5K
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…	57	1,620	80	$60	$28.4K
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,…	96	1,630	90	$30	$22K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	12	100	150	$10	$19.2K

Showing 1–10 of 25

Nearby Providers

Other providers in the same ZIP code as Everest Urgent Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Health Services Inc	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.8M
Delaware County Department Of Human Services	PA	Case Management Agency	$0	$25.7M
Holcomb Associates, Inc.	PA	Clinic/Center	$0	$20.1M
Care First Nursing	PA	Home Health Agency	$0	$16.5M
Michael Thevar	PA	Mental Health Counselor	$0	$13.3M
Successful Aging Care Net Inc	PA	Home Health Agency	$0	$11.1M
Greater Homecare Services Inc.	PA	In Home Supportive Care Agency	$0	$8.1M
Augie Wallace	PA	Home Health Aide	$0	$6.9M
Harwood House	PA	Substance Abuse Rehabilitation Facility	$0	$6.3M
Richard Kareha	PA	Optometrist	$13.7K	$0

Everest Urgent Care — Billing Profile & Reimbursement Data

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Everest Urgent Care — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References