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.

Mountain Comprehensive Health Corporation (NPI 1902980865)

Field	Value
Entity Type	Organization
Organization	Mountain Comprehensive Health Corporation
Address	226 Medical Plaza Ln
City	Whitesburg
State	KY
ZIP	41858
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$62.3M
Medicare	$0

Key Findings

Payer mix is effectively single‑payer: this provider reports none (no Medicare billing on file) and $62.3M in lifetime Medicaid revenue, indicating that Medicaid is the dominant — effectively sole — public payer represented in the claims dataset for this entity. Analysts should treat Medicaid utilization as the primary lens for assessing financial and operational behavior.

Revenue is highly concentrated in a few outpatient evaluation-and-management and a single unidentified code: the top 3 Medicaid codes account for 62.6% of total Medicaid revenue, led by 99214 ($16M, 31.1%), 99213 ($11.9M, 23.1%), and 0241U ($4.3M, 8.4%). This concentration implies that a small set of services drives most Medicaid dollars for the practice.

The clinical footprint is dominated by high-volume primary care E/M visits: 99214 has 348.9K claims at $46 avg paid/claim and 99213 has 362K claims at $33 avg paid/claim, reflecting a large established‑patient panel and substantial visit throughput consistent with the Primary Care Clinic/Center taxonomy. These volumes suggest operational focus on frequent office-based management of ambulatory patients and substantial clinician time spent on moderate- and low-complexity visits.

On competitive standing for key service lines, the provider is a statewide leader: 99214 ranks #6 of 2462 providers in-state (100th percentile; extreme outlier) and 99213 ranks #7 of 3339 providers in-state (100th percentile; extreme outlier), while 0241U ranks #1 of 51 providers in-state (100th percentile; extreme outlier). Those rank/percentile positions indicate dominant market share for these codes within Kentucky and far exceed typical state volumes.

The provider’s billing mix shows broad primary-care–adjacent services beyond standard E/M visits, including high-volume FQHC-style encounters and specialty-support services: G0467 (176K claims, $1.4M, rank #1 of 44, 100th percentile), 76815 fetal ultrasound (46.3K claims, $1.2M, rank #1 of 81, 100th percentile), 90832 psychotherapy (61.4K claims, $2.3M, rank #11 of 603, 98th percentile), and 92014 ophthalmology exams (18.2K claims, $1.1M, rank #10 of 710, 99th percentile). This mix suggests the organization operates as a broad ambulatory clinic delivering obstetric, behavioral health, eye care, and federally qualified health center–style visits in addition to core primary care.

Laboratory and point-of-care testing are material revenue contributors and demonstrate high throughput: 80305 (72.8K claims, $727.8K, rank #3 of 452, 100th percentile), 87880 (69.8K claims, $977.7K, rank #8 of 776, 99th percentile), 80061 (51.4K claims, $462.8K, rank #6 of 219, 98th percentile), 80050 (24.8K claims, $868.2K, rank #4 of 82, 96th percentile), and 82607 (41.1K claims, $452K, rank #1 of 156, 100th percentile). Coupled with J0696 ceftriaxone injections (25.5K claims, $356.6K, rank #1 of 348, 100th percentile), these figures indicate substantial on-site diagnostics and procedure capacity that payers should account for in utilization reviews and contracting.

There is a meaningful preventive and care‑coordination component to the practice: preventive well visits 99396 (11.4K claims, $954.3K, rank #1 of 263, 100th percentile) and 99395 (6.3K claims, $419.6K, rank #2 of 215, 100th percentile) appear alongside targeted case management T2023 (8K claims, $2.4M, rank #50 of 525, 91th percentile). These items indicate an established preventive care program plus recurring case-management billing that contributes to recurring monthly revenue streams.

The provider has long tenure in the NPI file (enumerated 2006-10-25 (~20 years ago)), and the combination of sustained presence plus extreme outlier ranks across many state-level codes suggests an established regional footprint. For payers and network planners this profile signals an entity with significant Medicaid volume and potential leverage in negotiations and in statewide service capacity for primary care, diagnostics, and several ancillary services.

Medicaid: Complete Services Breakdown

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

289 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…	348,890	$50	$16M
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…	362,010	$30	$11.9M
0241U	N/A	40,050	$110	$4.3M
T2023	Targeted case management; per month	8,020	$300	$2.4M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	61,440	$40	$2.3M
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,…	69,590	$30	$1.7M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	175,960	$10	$1.4M
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	46,280	$30	$1.2M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	18,160	$60	$1.1M
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.	69,840	$10	$977.7K

Showing 1–10 of 289

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

Mountain Comprehensive Health Corporation — 20 of 25 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

289 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	239	310	830	$120	$3.7M
T2023	Targeted case management; per month	50	530	530	$300	$1.1M
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.	246	340	2,700	$40	$673.3K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	116	130	6,080	$40	$449.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	351	1,270	760	$80	$447.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	41	200	16,730	$10	$365.9K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	15	80	260	$270	$358.5K
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…	7	3,340	1,020	$30	$296K
0241U	N/A	1	50	1,460	$80	$254.2K
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…	6	2,460	580	$40	$245K

Showing 1–10 of 289

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mountain Comprehensive Health Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Van Breeding	KY	Family Medicine Physician	$186.4K	$1.2K
Mahmood Alam	KY	Pulmonary Disease Physician	$86.2K	$0
Meranda Ramey	KY	Nurse Practitioner	$8.6K	$70K
Gregory Dye	KY	Family Medicine Physician	$72K	$0
Kevin Davis	KY	Medical Physician Assistant	$9.4K	$58.7K
April Hall-slone	KY	Internal Medicine Physician	$53.8K	$0
Brittany Bobrowski	KY	Family Medicine Physician	$29.6K	$22.2K
Kristin Delaney	KY	Family Nurse Practitioner	$32.2K	$0
Martha Combs-woolum	KY	Internal Medicine Physician	$15.8K	$0
Shannon Rutherford	KY	Adult Health Nurse Practitioner	$8.1K	$7.5K

Nearby Providers

Other providers in the same ZIP code as Mountain Comprehensive Health Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$33.4M
Mending Hearts	KY	Supports Brokerage Agency	$0	$23M
Comfort Hills, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.8M
Salahadin Gharad	KY	Cardiovascular Disease Physician	$225.6K	$0
Padubidri Chandrashekar	KY	Cardiovascular Disease Physician	$121.5K	$0
Adnan Bhopalwala	KY	Cardiovascular Disease Physician	$98.5K	$0
Mary Hamilton	KY	Family Nurse Practitioner	$7.9K	$0
Mary Collins	KY	Family Nurse Practitioner	$6.5K	$0

Mountain Comprehensive Health Corporation — Billing Profile & Reimbursement Data

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Mountain Comprehensive Health Corporation — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References