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

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

Prime Healthcare Services-providence, LLC (NPI 1528301900)

Prime Healthcare Services-providence, LLC is a general acute care hospital provider located in Kansas City, Kansas. This profile covers 0 Medicare and 94 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	Prime Healthcare Services-providence, LLC
Address	8929 Parallel Pkwy
City	Kansas City
State	KS
ZIP	66112
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 3, 2013

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

94 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	12,390	$50	$582.2K
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.	9,500	$50	$474.8K
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.	7,440	$50	$372.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	2,000	$40	$73.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	7,260	$10	$72.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,700	$20	$59.5K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	9,930	$10	$49.7K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	7,120	$10	$42.7K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	3,330	$10	$33.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,750	$20	$29.8K

Showing 1–10 of 94

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Prime Healthcare Services-providence, LLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

94 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	31	50	300	$60	$648.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	42	60	280	$30	$295.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	42	60	230	$30	$292K
G0480	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…	9	10	180	$50	$273.4K
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.	16	200	260	$60	$216K
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.	15	110	320	$60	$205K
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.	20	270	310	$50	$184.5K
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.	18	40	280	$40	$160.9K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	24	30	570	$20	$112.7K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	99	110	120	$10	$103.1K

Showing 1–10 of 94

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adult Services Inc.	KS	Home Health Agency	$0	$26.2M
Best Choice Home Health	KS	Home Health Agency	$0	$20.5M
Locamp LLC	KS	Home Health Agency	$0	$17.9M
Kc Childrens Surgery Center LLC	KS	Ambulatory Surgical Clinic/Center	$0	$13.8M
Wyandot Center For Community Behavioral Healthcare, Inc.	KS	Community/Behavioral Health Agency	$0	$6.7M
Wolcott Foods LLC	KS	Meals Provider	$0	$5.3M
Trinity Home Health Services, Inc.	KS	Home Health Agency	$0	$3.5M
Eagle Case Management LLC	KS	Case Management Agency	$0	$3M
Medical-surgical Eye Care, P.A.	KS	Optometrist	$0	$2.1M
State Avenue Dental LLC	KS	Dentist	$0	$1.9M

Prime Healthcare Services-providence, LLC — Billing Profile & Reimbursement Data

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Prime Healthcare Services-providence, LLC — 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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