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

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

Mclean Cares, Inc. (NPI 1679849459)

Mclean Cares, Inc. is a internal medicine physician provider located in Warner Robins, Georgia. This profile covers 0 Medicare and 18 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	Mclean Cares, Inc.
Address	235 Margie Dr Ste 300
City	Warner Robins
State	GA
ZIP	31088
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 27, 2012

Payer Source	Total Paid
Medicaid	$213.6K
Medicare	$0

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

18 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…	5,280	$30	$174.2K
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…	520	$20	$12.4K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	1,540	$10	$9.2K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	140	$30	$4.6K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	110	$40	$4.2K
95923	In this procedure, the provider tests the sudomotor function of the autonomic nervous system to check functioning of nerves that supply sweat glands. The autonomic nervous system is that part of the…	70	$40	$3.2K
95921	The provider evaluates the function of the autonomic nervous system, which controls those body functions, such as heart rate, temperature regulation, and other functions that are involuntary. He uses…	120	$20	$2.8K
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…	20	$50	$1.1K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	90	$10	$1K
96103	N/A	20	$20	$400

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Mclean Cares, Inc. — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	420	920	370	$60	$360.6K
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…	110	820	390	$70	$245K
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…	183	230	100	$110	$97.1K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	116	160	270	$1	$10.6K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	3	10	190	$40	$8.4K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	8	40	260	$1	$5.1K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	4	10	90	$20	$4.9K
G0447	Face-to-face behavioral counseling for obesity, 15 minutes	95	100	1,180	$1	$4.4K
96103	N/A	5	10	140	$1	$4K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	29	30	120	$1	$3.7K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Regeneration Project LLC	GA	Community/Behavioral Health Agency	$0	$4.2M
William Freeman	GA	Specialist	$2.2M	$0
Warner Robins Partners	GA	Ophthalmologic Surgery Clinic/Center	$1.4M	$0
Women's Healthcare Of Middle Ga, Inc	GA	Obstetrics & Gynecology Physician	$0	$1.4M
Lakeview Surgery Center, LLC	GA	Ambulatory Surgical Clinic/Center	$987.4K	$0
Darryl Hodson	GA	Dermatology Physician	$914.2K	$0
Comprehensive Care Medical Offices, LLC	GA	Infectious Disease Physician	$0	$511.4K
Johnny Gayton	GA	Ophthalmology Physician	$438.5K	$0
Dinakara Shetty	GA	Internal Medicine Physician	$433.7K	$0
Darla Jackson	GA	Professional Counselor	$0	$405.1K

Mclean Cares, Inc. — Billing Profile & Reimbursement Data

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Mclean Cares, 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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Frequently Asked Questions

References