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

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

Centra Medical Group, LLC (NPI 1649228966)

Key Findings

Field	Value
Entity Type	Organization
Organization	Centra Medical Group, LLC
Address	3300 Rivermont Ave
City	Lynchburg
State	VA
ZIP	24503
Taxonomy	Family Medicine Physician
NPI Enumerated	May 5, 2006

Payer Source	Total Paid
Medicaid	$60.1M
Medicare	$0

CENTRA MEDICAL GROUP, LLC is effectively a Medicaid-focused provider: there is no Medicare billing on file while reported Medicaid revenue totals $60.1M, indicating the organization operates at scale primarily within the Medicaid program. This payer concentration means Medicaid reimbursement patterns drive the provider's financial footprint and service mix.

Revenue is highly concentrated in a small set of E/M codes: the precomputed top 3 Medicaid codes (99214, 99284, 99285) account for 53.7% of the provider's total Medicaid revenue. Individually those codes generated $12.3M (22.0%), $9.7M (17.3%), and $8M (14.3%) respectively, highlighting dependence on office and emergency department evaluation & management services.

The code mix implies a hybrid operation spanning primary care ambulatory visits and high-volume acute care: 99214 (223.3K claims, $55 avg paid/claim, $12.3M) and 99213 (129.5K claims, $48 avg, $6.2M) indicate large established-patient office visit volume, while 99284 (166.4K claims, $58 avg, $9.7M) and 99285 (97.4K claims, $82 avg, $8M) reflect substantial emergency department throughput. Hospital-based E/M activity is also material (e.g., 99232 at 115.6K claims, $27 avg, $3.1M), suggesting the provider bills across outpatient, ED, and inpatient settings.

CENTRA is a dominant statewide participant for multiple high-revenue codes: 99214 ranks #8 of 3523 providers in VA (100th percentile, labeled an "extreme outlier"), 99284 ranks #4 of 620 (100th percentile, "extreme outlier"), and 99285 ranks #5 of 340 (99th percentile, "notably above typical"). These rank/percentile placements indicate the provider is far above typical state volume for core E/M services and functions as a major competitor in Virginia for those code lines.

Hospital inpatient and observation services are a clear revenue driver. Codes tied to inpatient care such as 99232 (115.6K claims, $27 avg, $3.1M; rank #3 of 398, 99th percentile), 99222 (12.1K claims, $53 avg, $641.9K; rank #1 of 183, 100th percentile) and 99239 (12.7K claims, $51 avg, $650K; rank #6 of 139, 96th percentile) show unusually high statewide standing for initial and subsequent hospital care E/M services.

Behavioral health and related therapy services form a meaningful secondary service line: H2033 (40.2K claims, $118 avg, $4.7M) contributes 8.5% of Medicaid revenue and ranks #10 of 78 (88th percentile), while psychiatric evaluation/psychotherapy codes such as 90792 ($1.4M, rank #4 of 231, 99th percentile) and 90834 ($337.9K, rank #48 of 661, 93rd percentile) are also present. The mix of H2033, 90792, 90791, 90834 and 97153 suggests the provider delivers multisystemic and individual behavioral health services alongside general medical care.

Volume-driven, lower per-claim payments characterize the largest revenue lines: the highest-revenue codes combine very large claim counts with modest average paid/claim (for example 99214 has 223.3K claims at $55 avg, 99284 has 166.4K claims at $58 avg, and 99232 has 115.6K claims at $27 avg). This pattern indicates that overall Medicaid revenue is more a function of throughput than high per-encounter receipts, consistent with high-volume ambulatory and ED operations.

The provider has long tenure in the NPI file, enumerated 2006-05-05 (~20 years ago), and that longevity together with the extreme outlier rankings for multiple high-volume codes suggests an established, high-capacity clinical operation within Virginia's Medicaid market. Sustained high ranks across office, ED, inpatient, and behavioral-health codes point to diversified service lines concentrated under a Medicaid-centered payer mix.

Medicaid: Complete Services Breakdown

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

254 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…	223,290	$60	$12.3M
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.	166,440	$60	$9.7M
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.	97,400	$80	$8M
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…	129,460	$50	$6.2M
H2033	Multisystemic therapy for juveniles, per 15 minutes	40,240	$120	$4.7M
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…	115,640	$30	$3.1M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	9,900	$140	$1.4M
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.	38,860	$30	$1.3M
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…	21,580	$60	$1.3M
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…	10,380	$80	$872.3K

Showing 1–10 of 254

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Centra Medical Group, LLC — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

254 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2033	Multisystemic therapy for juveniles, per 15 minutes	10	80	5,390	$210	$3.8M
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…	45	90	4,220	$210	$1.6M
G9012	Other specified case management service not elsewhere classified	65	120	2,160	$220	$1.6M
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.	5	340	160	$130	$1.3M
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.	44	630	90	$140	$1.1M
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.	104	140	3,240	$160	$1M
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.	4	620	70	$120	$1M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	47	90	1,030	$260	$977.2K
J0585	Injection, onabotulinumtoxina, 1 unit	14	20	750	$540	$871.7K
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.	91	180	2,950	$140	$783.2K

Showing 1–10 of 254

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$345.3M
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Prisma Health University Medical Group	SC	Family Medicine Physician	$0	$171.7M
Florida Clinical Practice Association Inc	FL	Surgery Physician	$0	$79.3M
Prisma Health Medical Group-midlands	SC	Multi-Specialty Clinic/Center	$0	$77.6M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Presbyterian Healthcare Services	NM	Rural Acute Care Hospital	$0	$47.6M
Presbyterian Healthcare Services	NM	Rural Acute Care Hospital	$0	$40.9M
Presbyterian Healthcare Services	NM	Critical Access Hospital	$0	$33.1M
Presbyterian Healthcare Services	NM	General Acute Care Hospital	$0	$21.6M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centra Health Inc	VA	General Acute Care Hospital	$0	$78.6M
Presbyterian Homes & Family Services, Inc	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$28.9M
Centra Outpatient Rehabilitation Services LLC	VA	Physical Therapist	$0	$7M
Shields Callahan	VA	MOHS-Micrographic Surgery Physician	$526.4K	$0
Audrey Graham	VA	Diagnostic Radiology Physician	$290K	$0
Alexandra Hickman	VA	Dermatology Physician	$224.1K	$0
Anita Hilliard	VA	Specialist	$219.4K	$0
Kappa Peddy	VA	Dermatology Physician	$200.9K	$0
Jennifer Mahan	VA	Physician Assistant	$178.5K	$0
Robert Brindle	VA	Diagnostic Radiology Physician	$168.3K	$0

Centra Medical Group, LLC — 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