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

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

Kings Daughters Medical Specialties Inc (NPI 1669791323)

Kings Daughters Medical Specialties Inc is a family medicine physician provider located in Ashland, Kentucky. This profile covers 0 Medicare and 40 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	Kings Daughters Medical Specialties Inc
Address	2201 Lexington Ave
City	Ashland
State	KY
ZIP	41101
Taxonomy	Family Medicine Physician
NPI Enumerated	May 20, 2010

Payer Source	Total Paid
Medicaid	$6.7M
Medicare	$0

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

40 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	98,500	$20	$2.1M
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…	28,500	$30	$883.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	19,550	$40	$762.3K
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…	12,070	$60	$736.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10,600	$50	$508.8K
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…	5,680	$70	$408.7K
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…	10,150	$30	$324.9K
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…	6,470	$30	$181.2K
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…	7,040	$20	$168.9K
99220	N/A	2,640	$60	$150.5K

Showing 1–10 of 40

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Kings Daughters Medical Specialties Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	10	10	600	$260	$1.1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	8	10	530	$90	$316.8K
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…	695	3,340	1,020	$30	$296K
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…	135	160	420	$140	$270.5K
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…	205	2,460	580	$40	$245K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	9	10	1,740	$80	$241.5K
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…	7	470	770	$20	$188.2K
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…	6	290	520	$30	$156.6K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	200	220	2,810	$10	$94.7K
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…	5	290	200	$70	$91.5K

Showing 1–10 of 40

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kings Daughters Medical Specialties Inc.	KY	Cardiovascular Disease Physician	$0	$6.3M
Robert Fried	KY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$719.4K	$0
Terry Justice	KY	Radiation Oncology Physician	$597.6K	$0
Ibraiz Iqbal	KY	Interventional Cardiology Physician	$197K	$392.3K
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
Shamseldeen Mahmoud	MO	Neuroradiology Physician	$109.5K	$474K
Eric Hoyer	WY	Diagnostic Radiology Physician	$534.9K	$0
Jeffrey Lopez	KY	Radiation Oncology Physician	$401.8K	$0
Sonya Kella	MN	Diagnostic Radiology Physician	$301.4K	$50.4K
Aijaz Yazdani	KY	Pulmonary Disease Physician	$79.8K	$268K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ashland Hospital Corporation	KY	General Acute Care Hospital	$0	$222.9M
Pathways, Inc.	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$95.4M
Pathways Inc	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$82.2M
A Brighter Future	KY	Community/Behavioral Health Agency	$0	$39.8M
A Center 4 Change	KY	Counseling Psychologist	$0	$22M
Fivco Add Cdo As Fiscal Agent	KY	Supports Brokerage Agency	$0	$21M
Our Lady Of Bellefonte Hospital Inc	KY	General Acute Care Hospital	$0	$12.1M
Advocate Medical Services, LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$10.6M
Ultimate Care Behavioral Health Services	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.6M
Wecare Medical, LLC	KY	Oxygen Equipment & Supplies (DME)	$0	$9.9M

Kings Daughters Medical Specialties Inc — Billing Profile & Reimbursement Data

Sign up for Kings Daughters Medical Specialties Inc — Billing Profile & Reimbursement Data policy alerts

Kings Daughters Medical Specialties Inc — Billing Profile & Reimbursement Data

Sign up for Kings Daughters Medical Specialties Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References