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

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

Urgencare, LLC (NPI 1598223844)

Urgencare, LLC is a urgent care clinic/center provider located in Lagrange, Georgia. This profile covers 0 Medicare and 15 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	Urgencare, LLC
Address	2169 W Point Rd Ste 300
City	Lagrange
State	GA
ZIP	30240
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	March 6, 2019

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

15 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…	7,480	$70	$523.4K
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…	2,500	$90	$220.2K
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…	1,620	$90	$140.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	2,990	$30	$101.6K
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…	350	$110	$37.6K
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.	4,400	$10	$35.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	3,370	$10	$30.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	220	$20	$5.2K
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…	30	$110	$3.4K
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,…	30	$70	$2.1K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Urgencare, LLC — 0 of 15 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

15 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…	132	920	370	$60	$360.6K
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…	190	820	390	$70	$245K
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,…	304	360	370	$50	$153.6K
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…	43	310	90	$90	$136.3K
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…	61	230	100	$110	$97.1K
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…	129	160	180	$80	$68K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	81	130	480	$20	$59.9K
S9083	Global fee urgent care centers	21	20	320	$80	$58.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	16	160	260	$30	$54.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	45	260	350	$10	$30.5K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Emory Clinic Inc	GA	Ambulatory Surgical Clinic/Center	$212.1K	$2.1M
Troup County Emergency Medical Services Inc	GA	Ambulance	$680.9K	$119.6K
Robert Stout	GA	Internal Medicine Physician	$529.3K	$0
Amir Usman	GA	Internal Medicine Physician	$505.2K	$0
Arnold Smalls	GA	Internal Medicine Physician	$495.6K	$0
Myles Jerdan	GA	Dermatology Physician	$413.1K	$0
Richard Ingram	GA	Internal Medicine Physician	$409.8K	$0
Air Evac Ems, Inc.	GA	Air Ambulance	$385.5K	$0
Pathways Center For Behavioral And Developmental Growth	GA	Community/Behavioral Health Agency	$0	$340.3K
Lawrence Gynther	GA	Hematology & Oncology Physician	$338K	$0

Urgencare, LLC — Billing Profile & Reimbursement Data

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Urgencare, 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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