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

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

Medical Care PLLC (NPI 1851537260)

Medical Care PLLC is a family medicine physician provider located in Elizabethton, Tennessee. This profile covers 0 Medicare and 109 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	Medical Care PLLC
Address	1500 W Elk Ave
City	Elizabethton
State	TN
ZIP	37643
Taxonomy	Family Medicine Physician
NPI Enumerated	January 7, 2009

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

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

109 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…	102,200	$50	$4.6M
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…	79,310	$40	$2.8M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	19,160	$80	$1.5M
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	27,470	$30	$933.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	16,300	$50	$733.5K
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,…	14,500	$30	$449.3K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	8,780	$40	$342.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,230	$70	$287.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3,660	$70	$249K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,450	$70	$176.5K

Showing 1–10 of 109

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Medical Care PLLC — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

109 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	16	40	200	$20	$234.7K
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…	24	3,760	610	$40	$202.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	93	520	470	$70	$187K
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…	46	4,050	620	$30	$183.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	163	480	580	$60	$174.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	59	510	240	$70	$133.7K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	1	200	300	$60	$106K
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…	653	1,080	120	$80	$90.7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	70	620	740	$20	$88.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	50	420	150	$80	$81.8K

Showing 1–10 of 109

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Silver Angels Of Tennessee - Carter, LLC	TN	In Home Supportive Care Agency	$0	$19.6M
Ocoee Hillview Health Center LLC	TN	Skilled Nursing Facility	$0	$11M
Mountain States Health Alliance	TN	General Acute Care Hospital	$0	$7.2M
Aging In Place, Inc.	TN	Home Health Agency	$0	$4.6M
Carter County Emergency & Rescue Squad, Inc	TN	Land Ambulance	$708.3K	$2.4M
Blue Ridge Medical Management Corporation	TN	Internal Medicine Physician	$0	$2.8M
Physical Therapy Services, P.A.	TN	Clinic/Center	$0	$2.2M
Med-trans Corporation	TN	Air Ambulance	$353.1K	$253.2K
Alainya Hare	TN	Podiatrist	$49.4K	$33.7K
Michelle Davenport	TN	Internal Medicine Physician	$55.8K	$0

Medical Care PLLC — Billing Profile & Reimbursement Data

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Medical Care PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cynthia Partain	TN	Family Medicine Physician	$262.5K	$0
John Testerman	TN	Orthopaedic Surgery Physician	$22.9K	$0
Derek Rhoton	TN	Physician Assistant	$19.2K	$0