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

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

Pikeville Medical Center Inc. (NPI 1528195864)

Pikeville Medical Center Inc. is a multi-specialty clinic/center provider located in Pikeville, Kentucky. This profile covers 0 Medicare and 256 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	Pikeville Medical Center Inc.
Address	911 Bypass Rd Bldg A
City	Pikeville
State	KY
ZIP	41501
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	February 27, 2007

Payer Source	Total Paid
Medicaid	$34.2M
Medicare	$0

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

256 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…	278,090	$30	$7.5M
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.	75,190	$60	$4.3M
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…	70,250	$40	$2.8M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	25,620	$90	$2.2M
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…	40,490	$40	$1.7M
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…	71,790	$20	$1.6M
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.	39,340	$40	$1.4M
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.	16,560	$80	$1.3M
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,…	55,400	$20	$886.3K
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…	11,310	$70	$814.3K

Showing 1–10 of 256

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Pikeville Medical Center Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

256 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.	10	280	7,150	$150	$3M
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.	49	240	4,710	$150	$2.6M
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.	27	280	5,700	$120	$2M
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.	109	180	1,870	$280	$1.5M
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.	144	170	2,610	$250	$1M
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.	134	180	2,960	$110	$672.4K
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.	52	160	2,900	$110	$610.8K
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…	11	210	1,340	$160	$568K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	15	40	1,770	$150	$567.9K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	29	60	170	$780	$500.2K

Showing 1–10 of 256

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pikeville Medical Center Inc	KY	General Acute Care Hospital	$0	$181.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Jefferson Radiology, PC	CT	Diagnostic Radiology Physician	$0	$14M
Rami Sartawi	NY	Vascular & Interventional Radiology Physician	$3.7M	$4.9M
Sujata Gutti	KY	Neurology Physician	$82.9K	$3.7M
Pamela Wells	TN	Diagnostic Radiology Physician	$827K	$0
Linda Armstrong	GA	Diagnostic Radiology Physician	$643.9K	$175.1K
Sainath Gaddam	TX	Interventional Cardiology Physician	$251.9K	$538.3K
Aalap Majmudar	KY	Internal Medicine Physician	$638.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dungarvin Kentucky, LLC - Pikeville	KY	Developmentally Disabled Services Day Training Agency	$0	$16.3M
Appalachian Community Care LLC	KY	Professional Counselor	$0	$13.1M
Joshua Raleigh	KY	Pediatric Dentistry	$0	$7.8M
Bhg Xxv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$228K	$6.3M
Renew Residential Treatment Services	KY	Substance Abuse Rehabilitation Facility	$0	$4.9M
Stepping Stones LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.6M
Chad Street	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$3.8M
Addiction Recovery Care LLC	KY	Substance Abuse Rehabilitation Facility	$0	$3.7M
Compassion Services	KY	Rural Health Clinic/Center	$0	$3.3M
Pikeville Radiology PLLC	KY	Diagnostic Radiology Physician	$0	$3.2M

Pikeville Medical Center 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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