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.

Modern Dermatology Of Kentucky LLC (NPI 1699382507)

Modern Dermatology Of Kentucky LLC is a dermatology physician provider located in Lexington, Kentucky. This profile covers 0 Medicare and 34 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	Modern Dermatology Of Kentucky LLC
Address	161 Lexington Green Cir Ste 100
City	Lexington
State	KY
ZIP	40503
Taxonomy	Dermatology Physician
NPI Enumerated	September 24, 2020

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

34 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…	29,110	$30	$756.9K
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…	15,610	$40	$655.7K
99203	The provider sees a new 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 provider…	9,780	$50	$440.1K
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…	4,250	$70	$301.8K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	4,080	$60	$261.1K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	6,240	$40	$255.7K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	4,570	$50	$214.7K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	9,290	$20	$139.3K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	5,480	$20	$87.6K
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,…	4,590	$20	$78K

Showing 1–10 of 34

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

Modern Dermatology Of Kentucky LLC — 14 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	67	130	2,450	$60	$382.4K
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…	225	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…	131	2,460	580	$40	$245K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	30	140	130	$110	$100.3K
77290	Before starting radiation therapy, a physician needs to know the location and size of the cancerous tumor, the radiation doses required to treat the tumor, and the positioning of the radiation beams…	8	10	80	$210	$87.5K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	40	60	1,020	$40	$83.8K
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…	37	1,020	120	$70	$62K
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…	240	870	480	$20	$61.8K
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,…	159	1,450	270	$30	$61K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	64	90	950	$30	$54.3K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Buckley	GA	MOHS-Micrographic Surgery Physician	$1.7M	$0
James Wharton	KY	Dermatology Physician	$924.5K	$0
John Roth	KY	Procedural Dermatology Physician	$506.2K	$0
James Allred	KY	Dermatology Physician	$309.8K	$0
Ronald Hall	KY	Dermatology Physician	$301.7K	$0
Andrea Blankenship	KY	Physician Assistant	$130K	$0
Rebecca Davies	KY	Adult Health Nurse Practitioner	$95.8K	$0
Timothy Smallwood	KY	Family Nurse Practitioner	$66K	$0
Harty Ashby	KY	Anatomic Pathology & Clinical Pathology Physician	$35.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Healthcare System, Inc	KY	General Acute Care Hospital	$0	$98.1M
Encore Adhc, LLC	KY	Adult Day Care Clinic/Center	$0	$51.9M
Center For Comprehensive Services, Inc	KY	Rehabilitation Hospital	$0	$28.7M
Lhcg Lxx, LLC	KY	Home Health Agency	$0	$27.1M
P & C Labs, LLC	KY	Clinical Medical Laboratory	$427.3K	$18M
Healthfirst Bluegrass Inc	KY	Federally Qualified Health Center (FQHC)	$0	$18.1M
Ndt Care Services, LLC	KY	Community/Behavioral Health Agency	$0	$17.5M
Lexington Urgent Care PLLC	KY	Urgent Care Clinic/Center	$0	$16.7M
Ballard Wright, Md, Psc	KY	Interventional Pain Medicine Physician	$0	$12.4M
Big Smiles Kentucky Psc	KY	Dentist	$0	$12.3M

Modern Dermatology Of Kentucky LLC — Billing Profile & Reimbursement Data

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Modern Dermatology Of Kentucky LLC — 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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