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

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

Prime Care Medical Clinic PLLC (NPI 1861702433)

Prime Care Medical Clinic PLLC is a internal medicine physician provider located in Dearborn, Michigan. 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	Prime Care Medical Clinic PLLC
Address	13840 W Warren Ave
City	Dearborn
State	MI
ZIP	48126
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 18, 2010

Payer Source	Total Paid
Medicaid	$5.5M
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
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…	38,930	$60	$2.5M
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…	18,760	$90	$1.6M
99442	N/A	6,900	$70	$455.1K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	3,140	$100	$311.2K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	2,070	$90	$186K
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,…	3,170	$40	$123.4K
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,…	2,650	$30	$69K
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…	5,230	$10	$52.3K
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…	370	$100	$38.3K
90756	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into…	1,410	$20	$25.3K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Michigan Distribution

Prime Care Medical Clinic PLLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. Michigan median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	176	4,380	1,000	$70	$289.9K
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…	106	4,770	1,060	$50	$247.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	258	270	1,950	$10	$131.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	232	520	710	$20	$112K
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…	564	1,170	170	$90	$107.9K
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…	765	1,860	220	$90	$96.9K
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…	1,106	2,000	260	$60	$84.2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	64	830	210	$70	$73.5K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	112	860	260	$70	$71.6K
82947	The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip.	35	200	550	$20	$69.3K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Psygenics Inc	MI	Clinical Social Worker	$0	$41.4M
Children's Dental Care PLLC	MI	Pediatric Dentistry	$0	$37.5M
Arab Community Center For Economic And Social Services Access	MI	Community/Behavioral Health Agency	$0	$25.1M
Alzohaili Medical Consultants Md PC	MI	Endocrinology, Diabetes & Metabolism Physician	$0	$13.3M
Patient First Medical Clinic PLLC	MI	Addiction Medicine (Internal Medicine) Physician	$0	$11.6M
Chase Pediatrics	MI	Primary Care Clinic/Center	$0	$11M
Basel Khatib, M.d., P.C.	MI	Pediatrics Physician	$0	$8.3M
Childrens Health Center	MI	Health Service Clinic/Center	$0	$7.3M
Mohamed Ayad, M.d., P.C.	MI	Family Medicine Physician	$0	$6.7M
Ali Sobh	MI	Dentist	$0	$6.3M

Prime Care Medical Clinic PLLC — Billing Profile & Reimbursement Data

Sign up for Prime Care Medical Clinic PLLC — Billing Profile & Reimbursement Data policy alerts

Prime Care Medical Clinic PLLC — Billing Profile & Reimbursement Data

Sign up for Prime Care Medical Clinic PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References