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

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

Summit Medical Group, Inc. (NPI 1881026169)

Summit Medical Group, Inc. is a urgent care clinic/center provider located in Highland Heights, Kentucky. This profile covers 0 Medicare and 21 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	Summit Medical Group, Inc.
Address	2626 Alexandria Pike
City	Highland Heights
State	KY
ZIP	41076
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	August 8, 2013

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

21 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…	47,110	$40	$1.7M
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…	23,010	$60	$1.3M
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…	11,840	$40	$521K
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.	16,450	$30	$509.9K
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.	24,760	$10	$346.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	11,410	$10	$159.7K
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,…	4,200	$30	$109.1K
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…	720	$60	$43.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	380	$110	$42.2K
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…	740	$10	$9.6K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Summit Medical Group, Inc. — 5 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	28	50	570	$110	$393.6K
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…	124	3,340	1,020	$30	$296K
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…	95	2,460	580	$40	$245K
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…	200	330	1,400	$30	$156.7K
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.	8	200	1,020	$30	$98.2K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	242	250	1,080	$40	$82.9K
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…	13	310	330	$40	$71.3K
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…	546	1,020	120	$70	$62K
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…	372	870	480	$20	$61.8K
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,…	1,184	1,450	270	$30	$61K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Medical Group, Inc	KY	Family Medicine Physician	$0	$95.1M
Summit Medical Group, Inc	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.2M
Angelia Thompson	KY	Ophthalmology Physician	$1.8M	$381.3K
Saad Ashraf	GA	Pulmonary Disease Physician	$380.7K	$0
Eli Cianciolo	OH	Pain Medicine (Anesthesiology) Physician	$338.7K	$0
Shoaib Ahmad	OK	Pulmonary Disease Physician	$276.1K	$0
Charles Breen	KY	Ophthalmology Physician	$272.3K	$3.4K
Pawel Szczykutowicz	KY	Internal Medicine Physician	$268K	$0
William Willmott	KY	Sleep Medicine (Internal Medicine) Physician	$264.9K	$0
Ira Younger	IN	Ophthalmology Physician	$256.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Patient Aids Inc	KY	Durable Medical Equipment & Medical Supplies	$0	$7.3M
Forest Heis	KY	Orthopaedic Surgery Physician	$139.7K	$0
Christina Kurtzman	KY	Dermatology Physician	$127K	$0
Jonathan Slaughter	KY	Orthopaedic Hand Surgery Physician	$91.5K	$0
Kathryn Beaulieu	KY	Pediatrics Physician	$39.6K	$0
Nicholas Gates	KY	Orthopaedic Surgery Physician	$39.4K	$0
Patricia Rudd	KY	Clinical Social Worker	$37.6K	$0
Caitlyn Kenny	KY	Pediatrics Physician	$34.8K	$0
Michael Bennett	KY	Physician Assistant	$33.3K	$0
Jessica Johnson	KY	Physical Therapist	$30.7K	$0

Summit Medical Group, Inc. — Billing Profile & Reimbursement Data

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Summit Medical Group, 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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