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.

University Health Physicians (NPI 1669456257)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Health Physicians
Address	2301 Holmes St
City	Kansas City
State	MO
ZIP	64108
Taxonomy	Internal Medicine Physician
NPI Enumerated	December 6, 2005

Payer Source	Total Paid
Medicaid	$102.8M
Medicare	$0

This provider has no Medicare billing on file and reported $102.8M in lifetime Medicaid revenue, making its public payment footprint effectively single‑payer (Medicaid). Analysts should treat Medicaid as the dominant and sole observed claims source in the dataset when evaluating scale and payer exposure.

Revenue is highly concentrated in a small set of E/M services: the top three Medicaid codes (99214, 99213, 99284) account for 47.6% of this provider’s total Medicaid revenue. Specifically, 99214 generated $25.8M (28.7% of Medicaid revenue), 99213 generated $9.1M (10.1%), and 99284 generated $7.8M (8.7%), so nearly half of Medicaid dollars flow through a narrow set of outpatient and ED E/M codes.

The code mix indicates a multi‑setting internal medicine operation: very high-volume ambulatory established‑patient visits (99214, 99213), substantial emergency department E/M work (99284, 99285, 99283), inpatient subsequent and initial care (99232, 99233, 99222, 99223), plus procedural and ancillary lines (43239 upper endoscopy with biopsy, 45385 polypectomy, pathology codes 88305/, and echocardiography ). Together, these codes imply the provider bills across clinic, ED, inpatient, endoscopy, and diagnostic pathology/echo services rather than being a narrow office-only practice.

Claim volumes underline the operational scale: 99214 shows 228.4K claims at $113 avg paid/claim and 99213 shows 115.3K claims at $79 avg paid/claim, while other high-volume services include 99232 with 73.6K claims and 93010 with 93.5K claims. These high claim counts across multiple E/M and diagnostic codes point to large clinical throughput and recurring ambulatory and acute care demand within Medicaid.

Competitive standing within Missouri is pronounced: 99214 ranks #1 of 3166 providers in-state (100th percentile; extreme outlier), 99232 ranks #1 of 587 (100th percentile; extreme outlier), 43239 and 45385 also rank #1 in-state (100th percentile; extreme outlier), and a long list of other codes sit at top percentiles (many labelled “extreme outlier” or 100th percentile). This pattern indicates the provider is a dominant statewide player across multiple service lines rather than a modest local participant.

Multiple specific codes are flagged as statistical outliers in-state, with labels such as “extreme outlier” for high-volume E/M, inpatient, and procedure codes (examples: 99214, 99213, 99284, 99232, 43239, 45385). At the same time a few services show typical or unremarkable standing (for example 90960 is described as “typical, unremarkable” at the 85th percentile), indicating the outlier behavior is concentrated in core E/M, ED, inpatient, and procedural lines rather than uniformly across every specialty code.

The provider has a long tenure in the NPI registry (enumerated 2005-12-06, approximately 21 years ago), which supports interpretation that the high volumes and top-state ranks reflect sustained clinical operations and established referral or delivery patterns rather than a brief reporting anomaly. This longevity increases confidence that observed patterns represent steady-state business lines.

Because nearly half of Medicaid revenue is concentrated in three E/M codes (top 3 = 47.6%) and overall revenue is entirely from Medicaid in the available data, the provider’s Medicaid revenue picture is sensitive to changes in E/M demand or Medicaid reimbursement policy. Analysts should consider how policy or utilization shifts affecting 99214/99213/99284 could materially influence the provider’s financials given the observed concentration.

Medicaid: Complete Services Breakdown

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

219 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…	228,370	$110	$25.8M
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…	115,260	$80	$9.1M
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.	47,130	$170	$7.8M
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.	27,690	$250	$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…	73,570	$90	$6.9M
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.	73,900	$90	$6.3M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	38,190	$140	$5.3M
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…	16,220	$170	$2.8M
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…	14,280	$170	$2.4M
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…	8,760	$240	$2.1M

Showing 1–10 of 219

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

University Health Physicians — 23 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

219 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	9	600	140	$170	$384.1K
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.	2	950	120	$150	$288.2K
70355	The provider takes panoramic X–rays of the patient’s upper and lower jaws to diagnose a fracture or injury to the jaw.	2	10	6,050	$40	$267.5K
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.	4	1,260	220	$120	$242.4K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	1	20	30	$450	$147.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1	90	120	$250	$141.3K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	3	30	90	$340	$140.3K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	1	30	50	$650	$137.5K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	9	60	510	$70	$128.9K
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…	1	3,170	230	$70	$128.1K

Showing 1–10 of 219

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Abraham Poulose	KS	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Michael Cassell	MO	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Thomas Hocker	KS	MOHS-Micrographic Surgery Physician	$1.1M	$0
Manuel Camejo	MO	Ophthalmology Physician	$924.9K	$0
Nelson Sabates	KS	Ophthalmology Physician	$877.6K	$0
Kevin Pikey	KS	Ophthalmology Physician	$411K	$0
Rohit Krishna	MO	Ophthalmology Physician	$318.9K	$0
Timothy Walline	KS	Ophthalmology Physician	$252.9K	$0
Cielo Navato-dehning	MO	Physical Medicine & Rehabilitation Physician	$215.9K	$0
Matthew Sniegowski	KS	Ophthalmology Physician	$191.3K	$2.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Truman Medical Center, Incorporated	MO	General Acute Care Hospital	$0	$233.8M
The Children's Mercy Hospital	MO	Children's Hospital	$0	$221M
The Children's Mercy Hospital	MO	Pediatrics Physician	$0	$53.6M
Truman Medical Center, Incorporated	MO	Community/Behavioral Health Agency	$0	$37.8M
Bethel Home Healthcare LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$24.3M
Truman Medical Center, Incorporated	MO	Otolaryngology Physician	$0	$14.1M
The Children's Mercy Hospital	MO	Ambulance	$0	$13.4M
Help At Home, LLC	MO	Nursing Care Agency	$0	$5.2M
Truman Medical Center Incorporated	MO	Body Imaging Physician	$0	$4.6M
Truman Medical Center Incorporated	MO	Community/Behavioral Health Agency	$0	$4.6M

University Health Physicians — 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