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.

Elite Pain Management, LLC (NPI 1609257773)

Elite Pain Management, LLC is a pain medicine (physical medicine & rehabilitation) physician provider located in Springfield, Missouri. This profile covers 0 Medicare and 36 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	Elite Pain Management, LLC
Address	1230 E Kingsley St Ste C
City	Springfield
State	MO
ZIP	65804
Taxonomy	Pain Medicine (Physical Medicine & Rehabilitation) Physician
NPI Enumerated	June 15, 2015

Payer Source	Total Paid
Medicaid	$3.5M
Medicare	$0

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	17,200	$50	$774K
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.	14,710	$50	$676.7K
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…	8,040	$80	$627K
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…	14,180	$30	$425.3K
G0481	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…	3,100	$120	$360.1K
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…	860	$180	$156.6K
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…	1,590	$70	$109.5K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	1,150	$60	$67.8K
G0482	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…	430	$130	$57K
L0650	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid…	180	$280	$51.5K

Showing 1–10 of 36

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

Elite Pain Management, LLC — 5 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

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	8	20	740	$70	$279.4K
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.	3	130	450	$60	$158.5K
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…	5	60	440	$80	$155.6K
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…	57	3,170	230	$70	$128.1K
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…	111	4,310	300	$60	$110.8K
G0482	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…	8	10	560	$80	$105.2K
G0481	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…	3	20	170	$90	$101.9K
L0648	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on…	3	10	50	$610	$78.6K
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	3	10	40	$220	$74.5K
64450	The provider injects an anesthetic agent, steroid, or both close to a peripheral nerve or branch not represented by another code. Report this code for one or more injections during a single procedure.	5	10	640	$50	$60.7K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elite Pain Management, LLC	SC	Pain Medicine Physician	$0	$1.6M
David Tonkin	MO	Interventional Pain Medicine Physician	$367.4K	$91.2K
Alok Jain	MO	Psychiatry Physician	$21.6K	$157.2K
James Sigler	KS	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$63.8K	$0
Amanda Gilbert	MO	Psychiatric/Mental Health Nurse Practitioner	$11.7K	$2.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$758.9M
Phoenix Home Care, LLC	MO	Nursing Care Agency	$0	$199.5M
Phoenix Home Care, LLC	MO	In Home Supportive Care Agency	$0	$149M
Integrity Home Care, LLC	MO	Home Health Agency	$0	$115.7M
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$64.5M
Preferred Family Healthcare, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$23M
Premier Home Health Care, Inc.	MO	Home Health Agency	$0	$12.1M
Burrell, Inc.	MO	Community/Behavioral Health Agency	$0	$9.1M
2gethertech, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.5M
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$6.6M

Elite Pain Management, LLC — Billing Profile & Reimbursement Data

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Elite Pain Management, 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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