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

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

Bothwell Regional Health Center (NPI 1508239781)

Bothwell Regional Health Center is a general practice physician provider located in Sedalia, Missouri. This profile covers 0 Medicare and 92 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	Bothwell Regional Health Center
Address	3700 W 10th St
City	Sedalia
State	MO
ZIP	65301
Taxonomy	General Practice Physician
NPI Enumerated	November 10, 2015

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

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

92 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…	40,590	$50	$1.9M
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…	19,990	$60	$1.2M
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.	3,630	$90	$326.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	5,200	$40	$213.2K
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.	3,560	$60	$202.6K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	2,810	$70	$202.1K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	3,050	$30	$94.7K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	3,320	$30	$89.6K
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…	1,230	$60	$72.3K
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…	870	$80	$65.1K

Showing 1–10 of 92

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Bothwell Regional Health Center — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	300	600	140	$170	$384.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	93	110	2,100	$70	$364.3K
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.	112	950	120	$150	$288.2K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	17	20	740	$70	$279.4K
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.	129	1,260	220	$120	$242.4K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	124	130	450	$60	$158.5K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	28	30	50	$650	$137.5K
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…	47	3,170	230	$70	$128.1K
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…	152	590	260	$40	$120.5K
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…	38	4,310	300	$60	$110.8K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bothwell Regional Health Center	MO	General Acute Care Hospital	$0	$19.8M
Lester E Cox Medical Centers	MO	General Practice Physician	$0	$9.2M
Bassem Chaar	IL	Hematology & Oncology Physician	$1.2M	$120.5K
Mindy Vesperman	MO	Nurse Practitioner	$375.1K	$0
Enock Faustin	MO	Diagnostic Radiology Physician	$357.4K	$120
Trung Tran	MO	Interventional Cardiology Physician	$312.6K	$0
Randy Balmforth	MI	Diagnostic Radiology Physician	$98.2K	$178.4K
Douglas Kiburz	MO	Sports Medicine (Orthopaedic Surgery) Physician	$263.9K	$0
Matthew Roehrs	MO	Family Medicine Physician	$261.1K	$0
Mirian Boci	KS	Urology Physician	$234.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Therapy Center Of Pettis County, Inc	MO	Developmentally Disabled Services Day Training Agency	$0	$51.3M
Children's Therapy Center Of Pettis County, Inc	MO	Case Management Agency	$0	$33.7M
Pettis County Board Of Services For The Developmentally Disabled	MO	Case Management Agency	$0	$13.7M
Helping All People Pursue Independence (happi), Inc.	MO	Case Manager/Care Coordinator	$0	$10.6M
Shawn Cairer	MO	Developmentally Disabled Services Day Training Agency	$0	$8.4M
Pettis County Ambulance District	MO	Land Ambulance	$845.9K	$5.7M
Regional Health Care Clinic Inc	MO	Federally Qualified Health Center (FQHC)	$0	$5.9M
Children's Therapy Center Of Pettis County, Inc	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$4.9M
Springhealth Behavioral Health And Integrated Care Missouri, LLC	MO	Community/Behavioral Health Agency	$0	$4M
Riverside Pediatrics, Inc	MO	Primary Care Clinic/Center	$0	$4M

Bothwell Regional Health Center — 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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