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

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

Wiggins Primary Care (NPI 1740293257)

Wiggins Primary Care is a rural health clinic/center provider located in Wiggins, Mississippi. This profile covers 0 Medicare and 44 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	Wiggins Primary Care
Address	975 Hall St
City	Wiggins
State	MS
ZIP	39577
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	August 14, 2006

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

44 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…	32,030	$70	$2.3M
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…	6,710	$50	$362.3K
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,…	710	$70	$47.8K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	3,620	$10	$36.2K
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…	2,810	$1	$11.2K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	1,210	$10	$8.4K
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…	60	$80	$5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	40	$100	$4.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	10	$100	$1.3K
J1040	Injection, methylprednisolone acetate, 80 mg	150	$1	$150

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Wiggins Primary Care — 1 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

44 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…	55	1,910	930	$60	$278.7K
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…	211	1,670	720	$50	$196.4K
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,…	218	670	230	$60	$89.5K
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…	154	750	400	$20	$52.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	302	440	380	$30	$49.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	180	230	140	$90	$45.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	589	620	570	$10	$38K
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…	421	680	100	$50	$34.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	116	160	300	$10	$22.3K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	22	140	280	$10	$20.3K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital At Gulfport	MS	General Acute Care Hospital	$0	$87.5M
Kelley Debar	MS	Family Nurse Practitioner	$32.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kare-in-home Hospice, LLC	MS	Community Based Hospice Care Agency	$0	$9.3M
The Vision Center PA	MS	Optometrist	$0	$2.1M
Memorial Hospital At Gulfport	MS	General Acute Care Hospital	$0	$1.4M
Stone County Hospital, Inc.	MS	Critical Access Hospital	$0	$1.3M
Hannah Fore	MS	Gerontology Nurse Practitioner	$51.7K	$0
Joshua Alderman	MS	Acute Care Nurse Practitioner	$9.3K	$0

Wiggins Primary Care — Billing Profile & Reimbursement Data

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Wiggins Primary Care — 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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