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

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

Spectrum Medical Inc (NPI 1861597072)

Spectrum Medical Inc is a orthopaedic surgery physician provider located in Danville, Virginia. This profile covers 0 Medicare and 58 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	Spectrum Medical Inc
Address	109 Bridge St Ste 300
City	Danville
State	VA
ZIP	24541
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

58 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…	31,170	$50	$1.6M
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…	29,220	$50	$1.4M
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…	18,930	$40	$776.2K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	19,560	$30	$665.1K
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…	9,140	$70	$603.2K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	15,370	$30	$476.6K
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…	6,720	$60	$403.3K
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…	3,230	$90	$284.4K
99205	The provider sees a new 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 provider…	1,650	$100	$163.1K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	5,970	$20	$119.3K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Spectrum Medical Inc — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	29	400	1,910	$50	$412.6K
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.	173	400	2,060	$60	$407.3K
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…	74	3,520	370	$70	$280.7K
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…	174	4,010	290	$50	$199.8K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	58	200	1,180	$30	$162.8K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	77	130	520	$90	$144K
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).	14	30	180	$320	$121.7K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	16	90	290	$90	$118.5K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	88	120	450	$100	$110.2K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	1	20	200	$60	$108.1K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kurt Voos	VA	Orthopaedic Surgery of the Spine Physician	$430.9K	$0
Joseph Campbell	VA	Orthopaedic Surgery Physician	$275.9K	$5.5K
James Dailey	VA	Physical Medicine & Rehabilitation Physician	$224K	$0
John Mahoney	VA	Orthopaedic Surgery Physician	$175.7K	$1.2K
Eduardo Fraifeld	VA	Pain Medicine (Anesthesiology) Physician	$92.8K	$0
Ramon Ruberte Thiele	VA	Orthopaedic Surgery Physician	$56.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danville Regional Medical Center, LLC	VA	Rural Acute Care Hospital	$0	$65.1M
Crossroads Treatment Center Of Danville, PC	VA	Substance Use Disorder Rehabilitation Clinic/Center	$173.7K	$18.6M
Danville Physician Practices LLC	VA	Anesthesiology Physician	$0	$13M
L&g Support And Resources Co.	VA	Community/Behavioral Health Agency	$0	$12M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$10.3M
Calm Source, LLC	VA	Community/Behavioral Health Agency	$0	$10.1M
Royal Care Incorporated	VA	Home Health Agency	$0	$9.8M
Piedmont Access To Health Services, Inc	VA	Federally Qualified Health Center (FQHC)	$0	$9.1M
Prince Charles Home Healthcare Agency, LLC	VA	Home Health Agency	$0	$8.6M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$7.9M

Spectrum Medical Inc — 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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