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

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

The Wright Center Medical Group (NPI 1649836941)

Field	Value
Entity Type	Organization
Organization	The Wright Center Medical Group
Address	501 S Washington Ave
City	Scranton
State	PA
ZIP	18505
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 13, 2019

Payer Source	Total Paid
Medicaid	$106.1M
Medicare	$0

Key Findings

THE WRIGHT CENTER MEDICAL GROUP is an FQHC–taxonomized provider with no Medicare billing on file and $106.1M in lifetime Medicaid revenue, and its NPI was enumerated on 2019-05-13 (~7 years ago). The absence of Medicare revenue makes this effectively a Medicaid-focused operation in the data set, concentrating operational and reimbursement exposure on a single payer.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 99.0% of total Medicaid revenue, and T1015 alone represents $100.1M or 94.4% of the provider’s Medicaid revenue. This level of concentration indicates that changes to Medicaid policy, reimbursement for T1015, or auditable billing rules for that all-inclusive clinic visit code would have outsized financial impact.

T1015 (Clinic visit/encounter, all-inclusive) dominates the clinical footprint with 303.2K claims and an average paid/claim of $330, which is consistent with bundled, clinic-centered payment models used by FQHCs. The mix—very high-volume T1015 billing plus numerous E/M codes—supports an operational profile centered on high-throughput ambulatory primary care and comprehensive clinic services rather than fee-for-service specialty revenue.

G9012 (Other specified case management) contributes $4.7M (4.5% of Medicaid revenue) and ranks #9 of 316 providers in-state (97th percentile), indicating a material case-management or care-coordination program alongside core clinic services. This suggests investment in non-face-to-face management activities that are being captured and paid under Medicaid, consistent with population-health efforts within an FQHC structure.

Several E/M and hospital-related codes appear at high state ranks, for example 99213 (101K claims, $201.9K revenue) ranks #6 of 8867 providers in-state (100th percentile; extreme outlier) and 99223 (3.4K claims, $165.3K revenue) ranks #7 of 477 (99th percentile; extreme outlier). These patterns show substantial volume across routine office visits and inpatient/observation E/M codes, but per-claim Medicaid payments for many E/M codes are very low (e.g., 99213 avg paid/claim $2), implying that overall revenue is driven by bundled clinic payments (T1015) rather than high fee-for-service rates on individual E/M services.

Competitive standing in-state is dominant on the primary revenue driver: T1015 ranks #1 of 1691 providers in-state (100th percentile; extreme outlier), identifying THE WRIGHT CENTER MEDICAL GROUP as the preeminent biller for the all-inclusive clinic visit in Pennsylvania. Multiple other codes also place the provider in top percentiles (many labeled “extreme outlier”), demonstrating above-typical state volume across a range of ambulatory and related services.

The single-payer concentration and top-code dominance have strategic implications for contracting and operational risk: with no Medicare revenue and $106.1M coming from Medicaid, payer negotiations, program changes, or state-level adjustments to Medicaid clinic payments could materially affect financials. For analysts, this makes Medicaid policy and T1015 reimbursement the key levers to monitor for revenue exposure and forecasting.

Although the NPI was enumerated ~7 years ago, the scale of activity—303.2K T1015 claims and top-state ranks across many codes—indicates rapid attainment of FQHC-level Medicaid throughput. The combination of high claim volume and extreme percentile rankings suggests this entity operates a large, established clinic network or a high-volume single site that functions as a central Medicaid primary-care provider in its market.

Medicaid: Complete Services Breakdown

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

250 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	303,220	$330	$100.1M
G9012	Other specified case management service not elsewhere classified	17,470	$270	$4.7M
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…	100,950	$1	$201.9K
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…	10,910	$20	$196.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,370	$50	$165.3K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	6,360	$10	$89.1K
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…	39,450	$1	$78.9K
0012A	N/A	2,120	$30	$65.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	7,200	$10	$57.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	4,210	$10	$50.5K

Showing 1–10 of 250

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

The Wright Center Medical Group — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

250 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	1	1,690	760	$170	$1.2M
G9012	Other specified case management service not elsewhere classified	9	320	770	$260	$758K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	103	120	150	$100	$92.4K
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…	86	820	230	$80	$71.7K
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…	20	8,160	210	$60	$68.4K
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…	65	660	180	$70	$63.7K
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…	6	8,870	240	$40	$56.1K
99491	The provider, a physician or other healthcare professional, personally directs the evaluation and management of a patient with two or more chronic A physician or other qualified healthcare…	36	50	210	$90	$54.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	62	710	230	$70	$49.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	44	870	160	$70	$48.2K

Showing 1–10 of 250

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Wright Center Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Julio Ramos	PA	Rheumatology Physician	$1.4M	$550
Samir Pancholy	PA	Interventional Cardiology Physician	$485.6K	$0
Haitham Abughnia	PA	Internal Medicine Physician	$439.5K	$0
David Reynolds	PA	Gastroenterology Physician	$194.7K	$0
Eric Smith	PA	Internal Medicine Physician	$131.4K	$0
Elmo Baldassari	PA	Foot & Ankle Surgery Podiatrist	$107.4K	$1.7K
Anurag Bajaj	SD	Cardiovascular Disease Physician	$86.4K	$0
Pavan Irukulla	PA	Critical Care Medicine (Internal Medicine) Physician	$49.1K	$0

Nearby Providers

Other providers in the same ZIP code as The Wright Center Medical Group, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scranton Counseling Center	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$23.3M
Friendship House	PA	Adolescent and Children Mental Health Clinic/Center	$0	$22M
Kevin Olsen	PA	Cardiovascular Disease Physician	$298.1K	$0
David Hazzouri	PA	Dentist	$27.9K	$0

The Wright Center Medical Group — Billing Profile & Reimbursement Data

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The Wright Center Medical Group — 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