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.

New Lexington Clinic, Psc (NPI 1700803681)

New Lexington Clinic, Psc is a multi-specialty clinic/center provider located in Lexington, Kentucky. This profile covers 0 Medicare and 105 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	New Lexington Clinic, Psc
Address	1221 S Broadway
City	Lexington
State	KY
ZIP	40504
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

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

105 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	55,610	$50	$3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	27,580	$80	$2.2M
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…	33,150	$30	$928.1K
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…	18,680	$30	$616.3K
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…	7,150	$40	$293.2K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	4,530	$40	$176.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	3,840	$40	$134.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,840	$40	$71.8K
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…	3,780	$20	$60.5K
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…	570	$100	$56.3K

Showing 1–10 of 105

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

New Lexington Clinic, Psc — 2 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

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15	280	7,150	$150	$3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	28	240	4,710	$150	$2.6M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	159	280	5,700	$120	$2M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	159	180	1,870	$280	$1.5M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	151	170	2,610	$250	$1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	135	210	1,340	$160	$568K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	77	100	440	$320	$477.2K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	56	60	820	$110	$467.9K
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…	37	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…	196	3,340	1,020	$30	$296K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Lexington Clinic, Psc	KY	Clinical Medical Laboratory	$1.8M	$1.1M
New Lexington Clinic, Psc	KY	Ambulatory Surgical Clinic/Center	$2.3M	$12.2K
New Lexington Clinic, Psc	KY	Ambulatory Surgical Clinic/Center	$1.6M	$148.3K
Shailendra Chopra	KY	Body Imaging Physician	$876.7K	$0
John West	KY	Diagnostic Radiology Physician	$451.6K	$0
Sean Marzolf	KY	Dermatology Physician	$450.1K	$0
Timothy Averion-mahloch	KY	Diagnostic Radiology Physician	$431.1K	$0
Elaine Alexander	KY	Rheumatology Physician	$389.6K	$0
Robert Lavey	KY	Radiation Oncology Physician	$384.3K	$0
Falguni Amin-zimmerman	KY	Radiation Oncology Physician	$378.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Health System, Inc	KY	General Acute Care Hospital	$0	$85.5M
Kentuckyone Health Medical Group, Inc.	KY	Family Medicine Physician	$0	$38.9M
Maxim Healthcare Services Inc.	KY	Home Health Agency	$0	$20.5M
Hospice Of The Bluegrass, Inc	KY	Community Based Hospice Care Agency	$0	$17.9M
Columbus Medical Services, LLC	KY	Case Management Agency	$0	$12.1M
Hospice Of The Bluegrass, Inc	KY	Community Based Hospice Care Agency	$0	$9.3M
Horn And Associates In Rehabilitation PLLC	KY	Rehabilitation Practitioner	$0	$8.3M
Serenity Keepers	KY	Adult Mental Health Clinic/Center	$0	$7.9M
Lexington Surgery Center Ltd	KY	Ambulatory Surgical Clinic/Center	$1.3M	$5.4M
Cogent Healthcare Of Kentucky, Psc	KY	Internal Medicine Physician	$0	$4.4M

New Lexington Clinic, Psc — 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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