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.

Andy M. Fine, M.d., Inc (NPI 1508103961)

Andy M. Fine, M.d., Inc is a internal medicine physician provider located in Littleton, Colorado. This profile covers 0 Medicare and 56 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	Andy M. Fine, M.d., Inc
Address	20 W Dry Creek Cir
City	Littleton
State	CO
ZIP	80120
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 4, 2013

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

56 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…	27,470	$60	$1.7M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	7,020	$110	$792.9K
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…	2,160	$120	$257K
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…	4,560	$40	$200.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	2,090	$80	$171.2K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,790	$80	$143.4K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	4,360	$10	$48K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	6,120	$10	$42.8K
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…	470	$80	$37.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,130	$20	$36.1K

Showing 1–10 of 56

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

Andy M. Fine, M.d., Inc — 5 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

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	358	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…	53	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…	1,390	1,670	550	$100	$229.3K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	30	60	360	$30	$183.5K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	32	70	350	$30	$150K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	410	590	200	$80	$119.9K
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,…	452	690	140	$90	$118.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	18	720	130	$100	$110K
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…	469	630	830	$30	$102.9K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	306	410	890	$40	$101.6K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Life Choices	CO	Developmentally Disabled Services Day Training Agency	$0	$123.6M
Caps - Mental Health And Dui Services, LLC	CO	Community/Behavioral Health Agency	$0	$6.8M
Actualize Behavior Alternatives	CO	Clinical Social Worker	$0	$6.4M
Rocky Mountain Health & Rehab, LLC	CO	Physical Therapist	$0	$3.5M
Manojkumar Bupathi	CO	Hematology & Oncology Physician	$1.4M	$0
Functional Neurosurgical Ambulatory Surgery Center,llc	CO	Ambulatory Surgical Clinic/Center	$955.9K	$0
Arapahoe Surgicenter, LLC	CO	Ambulatory Surgical Clinic/Center	$452K	$353.4K
Charles Leonard	CO	Radiation Oncology Physician	$495.5K	$0
Littleton Day Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$384.3K	$0
Marie Weeks	CO	Radiation Oncology Physician	$355.2K	$0

Andy M. Fine, M.d., Inc — Billing Profile & Reimbursement Data

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Andy M. Fine, M.d., Inc — 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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