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

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

Baltimore Medical System Inc (NPI 1548266547)

Field	Value
Entity Type	Organization
Organization	Baltimore Medical System Inc
Address	3700 Fleet St Ste 200
City	Baltimore
State	MD
ZIP	21224
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 23, 2005
NPI Deactivated	May 13, 2023

Payer Source	Total Paid
Medicaid	$121.2M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $121.2M in lifetime Medicaid revenue, making its public claims footprint effectively single-payer (Medicaid) in scale. Analysts should treat Medicare-based comparisons as inapplicable for this entity and focus on Medicaid dynamics when assessing revenue and service mix.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 72.2% of this provider's total Medicaid revenue. Those top drivers are 99213 ($47.8M, 39.5%), 99214 ($24.1M, 19.9%), and T1015 ($15.5M, 12.8%), indicating most dollars flow through a small set of ambulatory visit codes.

The code mix and volumes point to a high-throughput primary care FQHC model: large volumes of established E/M codes (99213: 223.4K claims; 99214: 117.3K claims) alongside substantial T1015 clinic/all-inclusive billing suggest routine, ongoing chronic and episodic care delivered in clinic settings. A strong suite of preventive medicine codes (99391, 99392, 99393, 99394, 99395) further indicates broad age-range primary care services, including pediatric and adolescent well visits.

State-level rankings demonstrate dominant in-state positioning for core primary care codes: 99213 ranks #2 of 3275 providers in-state (100th percentile; extreme outlier) and 99214 ranks #8 of 3673 (100th percentile; extreme outlier), while 99394 ranks #1 of 317 providers (100th percentile). These percentile and rank signals identify the provider as a major Medicaid primary care volume leader in Maryland rather than a modest participant.

Operational nuances appear in ancillary and programmatic services: T1015 is notable at 169.8K claims and ranks #3 of 58 providers in-state (96th percentile; notably above typical), consistent with an FQHC all-inclusive clinic billing model. Diabetes education G0108 ranks #1 of 6 providers in-state (100th percentile; notably above typical) but behavioral health counseling H0004 sits at a typical volume (rank #137 of 382, 64th percentile), suggesting stronger emphasis on primary medical and chronic disease management than on billable behavioral-health minutes.

The provider runs very high claim volumes for some low-reimbursement items, illustrating scale of preventive operations: 90686 appears with 34.1K claims at $1 avg paid/claim for $34.1K revenue and ranks #2 of 522 providers in-state (100th percentile; extreme outlier). This pattern indicates large-scale immunization activity that contributes modestly to revenue but substantially to service throughput and public-health operations.

Claim-count magnitudes reinforce access-oriented throughput: 223.4K claims for 99213 and 117.3K claims for 99214, together with sizable counts across child and adolescent preventive codes (for example, 99391: 28.9K claims; 99392: 26.9K claims), point to a high-volume ambulatory network treating a broad population mix. For payers evaluating network capacity or diversion risk, these volumes signal significant primary-care appointment capacity concentrated in this single organization.

The provider has an established tenure in the NPI file (NPI enumerated 2005-06-23 (~21 years ago)), which, combined with the statewide high-percentile rankings, suggests a long-standing, stable role in Maryland’s Medicaid primary care landscape. Analysts assessing contracting or capacity should factor this longevity alongside the pronounced Medicaid concentration and code-level dominance.

Medicaid: Complete Services Breakdown

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

159 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…	223,370	$210	$47.8M
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…	117,350	$210	$24.1M
T1015	Clinic visit/encounter, all-inclusive	169,790	$90	$15.5M
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,…	41,450	$220	$8.9M
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…	28,910	$220	$6.4M
99392	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…	26,920	$230	$6.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	19,560	$230	$4.5M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	13,380	$220	$3M
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…	7,780	$210	$1.7M
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	5,910	$190	$1.1M

Showing 1–10 of 159

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Baltimore Medical System Inc — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

159 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	60	380	$170	$4.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	137	380	1,450	$60	$459K
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…	8	3,670	680	$90	$310K
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…	2	3,280	610	$80	$296.1K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	14	20	60	$810	$256.6K
99392	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…	2	330	800	$110	$228.7K
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…	2	290	730	$100	$212.2K
90832	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…	471	610	520	$50	$178.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1	320	290	$120	$128K

Showing 1–10 of 159

Related Providers

Other providers that share a Tax Identification Number (TIN) with Baltimore Medical System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kristina Lynch	MD	Family Medicine Physician	$244.7K	$0
Dahlia Reid	MD	Internal Medicine Physician	$154.8K	$0
Cathy Larrain	MD	Geriatric Medicine (Internal Medicine) Physician	$98.5K	$0
Vishal Sethi	MD	Infectious Disease Physician	$57.6K	$0
Kelli Mccallum	MD	Family Nurse Practitioner	$42.3K	$0
John Roxborough	DC	Family Medicine Physician	$24.6K	$760
Alexander Daniel	MD	Oral and Maxillofacial Surgery (Dentist)	$5.4K	$0
Maren Ketcham	DC	Internal Medicine Physician	$0	$4.4K

Nearby Providers

Other providers in the same ZIP code as Baltimore Medical System Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medi-rents & Sales, Inc.	MD	Oxygen Equipment & Supplies (DME)	$0	$85.8M
Johns Hopkins Pharmaquip Inc	MD	Home Infusion Therapy Pharmacy	$0	$81.8M
Johns Hopkins Pediatrics At Home, Inc.	MD	Durable Medical Equipment & Medical Supplies	$0	$45.6M
Johns Hopkins Home Care Group, Inc	MD	Case Management Agency	$0	$43M
Community Wellness Outpatient Mental Health Center LLC	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$27.6M
Key Point Health Services, Inc	MD	Mental Illness Community Based Residential Treatment Facility	$0	$19.2M
Patient First Maryland Medical Group PLLC	MD	Family Medicine Physician	$0	$18.8M
Eastern Avenue Health Solutions Inc.	MD	Methadone Clinic	$340.5K	$16.6M
Community Wellness Psychiatric Rehabilitation Program LLC	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
Dynamic Health Care LLC	MD	Mental Health Counselor	$0	$9.3M

Baltimore Medical System Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References