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.

Mountain Family Practice Clinic Of Manchester Inc (NPI 1689919078)

Mountain Family Practice Clinic Of Manchester Inc is a rural health clinic/center provider located in Manchester, Kentucky. This profile covers 0 Medicare and 28 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	Mountain Family Practice Clinic Of Manchester Inc
Address	108 Manchester Sq Shopping Center
City	Manchester
State	KY
ZIP	40962
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 11, 2012

Payer Source	Total Paid
Medicaid	$4.6M
Medicare	$0

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	73,250	$30	$2.2M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	34,280	$40	$1.4M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	21,860	$20	$480.9K
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.	13,660	$10	$163.9K
H0038	Self‑help/peer services, per 15 minutes	15,870	$10	$158.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	1,740	$30	$57.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	3,270	$10	$35.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	490	$50	$24.6K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	2,040	$10	$20.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	260	$80	$20.1K

Showing 1–10 of 28

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

Mountain Family Practice Clinic Of Manchester Inc — 4 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

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0038	Self‑help/peer services, per 15 minutes	65	320	3,070	$50	$678.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	192	340	2,700	$40	$673.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	893	1,270	760	$80	$447.2K
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…	69	3,340	1,020	$30	$296K
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…	1,367	2,460	580	$40	$245K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	600	600	$40	$207.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	235	500	250	$60	$152.8K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	260	290	670	$20	$103.8K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	71	210	230	$40	$79.7K
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.	18	540	210	$20	$78.3K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital, Inc.	KY	Rural Acute Care Hospital	$0	$46.8M
Memorial Hospital Inc.	KY	Rural Health Clinic/Center	$0	$12.4M
Clay Community Foundations, LLC	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.4M
Air Evac Ems Inc	KY	Air Ambulance	$566.7K	$3.6M
Family Health Care Associates	KY	Rural Health Clinic/Center	$0	$4.1M
Cumberland Valley District Health Department	KY	Home Health Agency	$0	$2.8M
Clay County Fiscal Court	KY	Land Ambulance	$399.1K	$1.6M
Keerthana Karumbaiah	KY	Cardiovascular Disease Physician	$432.3K	$0
Gregory Wilkens	KY	Surgery Physician	$20.5K	$0

Mountain Family Practice Clinic Of Manchester Inc — Billing Profile & Reimbursement Data

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Mountain Family Practice Clinic Of Manchester 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