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.

Family Care Centers Inc. (NPI 1669563037)

Family Care Centers Inc. is a internal medicine physician provider located in E Stroudsburg, Pennsylvania. This profile covers 0 Medicare and 145 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	Family Care Centers Inc.
Address	206 E Brown St
City	E Stroudsburg
State	PA
ZIP	18301
Taxonomy	Internal Medicine Physician
NPI Enumerated	September 28, 2006

Payer Source	Total Paid
Medicaid	$11.1M
Medicare	$0

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

145 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…	52,420	$50	$2.8M
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…	65,220	$40	$2.7M
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…	9,960	$90	$926.1K
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…	9,230	$100	$877K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,670	$90	$666.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,500	$70	$406.9K
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…	2,490	$80	$201.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1,790	$90	$162.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	6,010	$20	$144.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	12,640	$10	$126.4K

Showing 1–10 of 145

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

Family Care Centers Inc. — 17 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

145 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1002	Rn services, up to 15 minutes	82	90	1,850	$400	$1.5M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	619	980	310	$50	$136.6K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	84	100	300	$130	$129.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	21	20	40	$1,340	$124.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	48	200	330	$60	$95.3K
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.	181	290	90	$290	$85.6K
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…	71	80	40	$580	$76.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	109	250	80	$140	$74.1K
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…	13	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…	13	8,160	210	$60	$68.4K

Showing 1–10 of 145

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lehigh Valley Hospital	PA	General Acute Care Hospital	$0	$64.3M
Lehigh Valley Physician Group	PA	Family Medicine Physician	$0	$21.9M
Lehigh Valley Physician Group	PA	Emergency Medicine Physician	$0	$16.3M
Lehigh Valley Hospital Pocono	PA	General Acute Care Hospital	$0	$11.9M
Hazleton Professional Services	PA	Internal Medicine Physician	$0	$8.3M
Lehigh Valley Physician Group	PA	Pediatrics Physician	$0	$7.6M
Family Care Centers Inc	PA	Family Medicine Physician	$0	$6.1M
Lehigh Valley Physician Group	PA	Pediatric Emergency Medicine (Emergency Medicine) Physician	$0	$5.9M
Eugene Grady	PA	Rheumatology Physician	$1.7M	$980
Joseph Zaladonis	PA	Specialist	$1.4M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matrix Behavior Solutions, LLC	PA	Behavior Analyst	$0	$75.6M
Loving Care Agency, Inc.	PA	Home Health Agency	$0	$27.4M
Gerald Negvesky	PA	Ophthalmology Physician	$446.1K	$0
Laszlo Szollas	PA	Interventional Pain Medicine Physician	$417.3K	$0
Gordon Fried	PA	Interventional Cardiology Physician	$305.5K	$130
Roger Componovo	PA	Adult Reconstructive Orthopaedic Surgery Physician	$299.8K	$0
Javed Malik	PA	Diagnostic Radiology Physician	$205.4K	$65.7K
Alan Westheim	PA	Dermatology Physician	$250.1K	$0
Samer Alkhuja	PA	Pulmonary Disease Physician	$243.9K	$2.7K
Mae Cheryl Laborde	PA	Adult Health Nurse Practitioner	$213K	$15.4K

Family Care Centers Inc. — Billing Profile & Reimbursement Data

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Family Care Centers Inc. — 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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