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NPI 1861418220 · Annapolis, MD · Interventional Pain Medicine Physician
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Advanced Pain Management Specialists, LLC is a interventional pain medicine physician provider located in Annapolis, Maryland. This profile covers 0 Medicare and 97 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Advanced Pain Management Specialists, LLC |
| Address | 810 Bestgate Rd Ste 220 |
| City | Annapolis |
| State | MD |
| ZIP | 21401 |
| Taxonomy | Interventional Pain Medicine Physician |
| NPI Enumerated | July 15, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $33.8M |
| Medicare | $0 |
This practice is effectively single-payer with respect to federal programs: there is no Medicare billing on file while Medicaid billing totals $33.8M in lifetime revenue, indicating its public-payer exposure is concentrated entirely in Medicaid. Analysts should treat Medicare comparators as inapplicable for this entity and focus competitive benchmarking within Maryland Medicaid data.
Revenue is highly concentrated in office-based evaluation and management visits: the top three Medicaid codes (99214, 99213, 99204) account for 93.8% of this provider’s total Medicaid revenue. The single largest code, 99214, generates $24M (71.5% of Medicaid revenue), followed by 99213 with $6M (17.7%) and 99204 with $1.6M (4.6%), signaling heavy dependence on face-to-face clinic visits for revenue.
The code mix indicates a high-throughput outpatient pain management clinic that combines large-volume E/M visits with interventional pain procedures and diagnostic testing. High volumes for 99214, 99213 and 99204 are paired with substantial procedural activity (examples include 64483, 64484, 64636, 64635, 64494) and electrodiagnostic studies (95911), which is consistent with a specialty practice that manages ongoing follow-up visits and performs image-guided injections and nerve procedures.
On statewide competitive standing, this provider is a dominant outlier for core E/M codes: 99214 ranks #3 of 3673 in-state and 99213 ranks #9 of 3275, both at the 100th percentile and described as extreme outliers. 99204 also ranks #5 of 934 providers (100th percentile, extreme outlier), indicating this practice operates at volumes far above typical Maryland peers for both new and established visit types.
Several interventional and diagnostic codes show top-in-state dominance or notably above-typical volumes, supporting a specialty procedural footprint rather than a generalist clinic. Examples include 64483 (#1 of 39, extreme outlier), 64484 (#1 of 15, 100th percentile), 95911 (#1 of 6, 100th percentile), 64636 (#1 of 9, 100th percentile) and 20611 (#1 of 19, 100th percentile), which together point to unusually high procedural throughput relative to other in-state providers.
High visit throughput is evident in claims and average payments for the highest-revenue codes: 99214 shows 293.2K claims at $82 avg paid/claim, 99213 shows 114.7K claims at $52 avg paid/claim, and 99204 shows 13.6K claims at $115 avg paid/claim. These claim volumes indicate substantial patient volume and frequent follow-up encounters driving most revenue rather than high-dollar single procedures.
The provider offers ancillary services and testing that complement interventional pain care, but these are a small share of revenue individually. Examples include instrumented presumptive drug screening (80307, 12.6K claims, $4 avg paid/claim), definitive drug testing (G0481 and G0482), dexamethasone injections J1100 (4.2K claims, $8 avg paid/claim), and durable medical equipment L0650 (127 claims, $836 avg paid/claim); many of these codes are at typical or modest state percentiles while a few are above typical, reflecting a broad service mix around the core E/M and procedural lines.
The NPI has long tenure in the data set, enumerated 2006-07-15 (~20 years ago), which aligns with the scale and entrenched market position reflected by extreme-volume rankings. For payer strategy and network planning, this longevity plus concentrated Medicaid dependence suggests the entity is an established Medicaid-focused pain practice with sustained patient throughput rather than a recently entered competitor.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
97 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… | 293,160 | $80 | $24M |
| 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… | 114,730 | $50 | $6M |
| 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… | 13,600 | $120 | $1.6M |
| 64483 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral). | 7,940 | $70 | $547.5K |
| 95886 | The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more… | 2,170 | $70 | $160.7K |
| 64484 | This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection in the lumbar or sacral region. The code applies to each additional level… | 3,450 | $40 | $134.7K |
| 97110 | Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with… | 2,780 | $50 | $130.8K |
| 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… | 1,360 | $100 | $130.4K |
| 95911 | In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of… | 780 | $160 | $126.5K |
| 64636 | In this add on procedure, the provider destroys the facet joint nerve of a lumbar or sacral spinal segment using neurolytic agents like heat, electric current, or a chemical compound. He makes use of… | 1,640 | $70 | $109.6K |
Showing 1–10 of 97
How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Maryland median
97 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 15 | 50 | 3,420 | $110 | $1.2M |
| 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. | 23 | 160 | 980 | $50 | $387.6K |
| 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… | 3 | 3,670 | 680 | $90 | $310K |
| 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… | 9 | 3,280 | 610 | $80 | $296.1K |
| 97530 | The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity. | 417 | 480 | 740 | $50 | $220.2K |
| G0482 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but… | 4 | 20 | 410 | $80 | $144.7K |
| 97110 | Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with… | 154 | 570 | 810 | $30 | $138K |
| 95910 | In this procedure, the provider performs seven or eight nerve conduction studies, a diagnostic test to evaluate the function, especially the electrical conduction ability of the motor and sensory… | 3 | 10 | 160 | $110 | $108K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 396 | 1,090 | 90 | $200 | $101.4K |
| 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… | 154 | 1,000 | 200 | $120 | $96.3K |
Showing 1–10 of 97
Other providers in the same ZIP code as Advanced Pain Management Specialists, LLC, ranked by combined Medicare and Medicaid revenue.
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