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    OpenPayerNPI Medicare & MedicaidPrime Healthcare Services Blue Springs, LLC
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    Prime Healthcare Services Blue Springs, LLC — Billing Profile & Reimbursement Data

    NPI 1912303579 · Blue Springs, MO · General Acute Care Hospital

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    Prime Healthcare Services Blue Springs, LLC is a general acute care hospital provider located in Blue Springs, Missouri. This profile covers 0 Medicare and 49 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPrime Healthcare Services Blue Springs, LLC
    Address201 Nw R D Mize Rd
    CityBlue Springs
    StateMO
    ZIP64014
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedNovember 10, 2014

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$10.5M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

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

    49 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.12,210$150$1.9M
    99284The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.6,210$280$1.8M
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.4,880$310$1.5M
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…9,780$110$1.1M
    80053The 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.8,620$110$973.5K
    X4014N/A2,240$330$748.2K
    X4011N/A1,620$380$611.6K
    87804The 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.3,550$150$522.4K
    93005The 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…3,230$60$197K
    71045In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…2,530$80$189.4K

    Showing 1–10 of 49

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Missouri median

    49 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    X4011N/A791105,700$340$3.2M
    X4014N/A2101,070$1,030$2.3M
    G0463Hospital outpatient clinic visit for assessment and management of a patient831002,240$80$2.2M
    X4003N/A65701,480$80$1.1M
    96374The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.47901,850$120$384.1K
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.70600140$170$384.1K
    93005The 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…471102,100$70$364.3K
    80053The 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.582401,740$40$353.4K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…63320980$40$352.7K
    99284The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.91950120$150$288.2K

    Showing 1–10 of 49

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Prime Healthcare Services Blue Springs, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Thad StephensMOUndersea and Hyperbaric Medicine (Emergency Medicine) Physician$309K$0
    Cherrie TermuloKSHospitalist Physician$269.1K$0
    Gerald MancusoMOInterventional Cardiology Physician$252K$0
    Brian HaasMOInternal Medicine Physician$217.9K$0
    Neal EricksonKSFamily Medicine Physician$217.4K$0
    Luis CouchonnalMOClinical Cardiac Electrophysiology Physician$173.4K$0
    Linda MccormickMOFamily Medicine Physician$163K$0
    Aman KhanKSPulmonary Disease Physician$160.8K$0
    Robert OttoKSPsychiatric/Mental Health Nurse Practitioner$160.4K$0
    Craig LundgrenMOInterventional Cardiology Physician$155.8K$0

    Nearby Providers

    Other providers in the same ZIP code as Prime Healthcare Services Blue Springs, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Harmony House Care Homes, Inc.MOIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$11.1M
    Harmony House Care Homes, Inc.MODevelopmentally Disabled Services Day Training Agency$0$9.4M
    Children's Mercy-cockerell And Mcintosh Pediatrics, IncMOPediatrics Physician$0$6.3M
    Insight Industry LLCMOIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$5.4M
    Central Jackson County Fire Protection DistrictMOLand Ambulance$529.8K$2.2M
    Mohsen TahaniMOPhysical Medicine & Rehabilitation Physician$515.3K$90.1K
    Loren HayesMOFamily Nurse Practitioner$401.1K$0
    Daniel HanonMOFoot & Ankle Surgery Podiatrist$187.4K$0
    Renato SandovalMOEndocrinology, Diabetes & Metabolism Physician$154.4K$0
    Daniel KeletiMORadiation Oncology Physician$151.8K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Missouri Providers
    3 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Missouri Distribution
    Prime Healthcare Services Blue Springs, LLC — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Missouri