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

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

Main Line Healthcare (NPI 1922077643)

Main Line Healthcare is a family medicine physician provider located in Newtown Square, Pennsylvania. This profile covers 0 Medicare and 96 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	Main Line Healthcare
Address	3803 West Chester Pike
City	Newtown Square
State	PA
ZIP	19073
Taxonomy	Family Medicine Physician
NPI Enumerated	March 15, 2006

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

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

96 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…	39,700	$40	$1.5M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	25,330	$60	$1.5M
S9083	Global fee urgent care centers	12,410	$120	$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…	27,110	$50	$1.3M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,710	$110	$528K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	61,270	$10	$428.9K
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…	2,080	$90	$180.7K
93000	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…	12,560	$10	$175.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3,160	$60	$173.9K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	6,890	$20	$165.3K

Showing 1–10 of 96

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Main Line Healthcare — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

96 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	39	400	360	$110	$571.8K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	23	30	180	$570	$331.3K
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…	537	540	1,490	$50	$316.4K
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…	19	8,160	210	$60	$68.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	29	550	160	$80	$58.1K
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…	61	8,870	240	$40	$56.1K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	274	310	70	$160	$53.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	610	90	$60	$50.1K
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…	107	260	40	$200	$49.4K
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…	90	1,210	100	$90	$45K

Showing 1–10 of 96

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health And Dental Care, Inc	PA	Federally Qualified Health Center (FQHC)	$0	$28.6M
Barry Jacobson	PA	Obstetrics & Gynecology Physician	$3M	$0
Daniel Lin	PA	Family Medicine Physician	$127.1K	$2.4M
Thais Moldovan	PA	Rheumatology Physician	$1.1M	$0
Grand View Hospital	PA	Ambulance	$481.8K	$131.7K
Jennifer Armstrong	PA	Medical Oncology Physician	$545.2K	$0
Amanulla Khaji	PA	Hospitalist Physician	$528.3K	$4.6K
Paul Marcotte	PA	Neurological Surgery Physician	$509K	$0
Theodore Plush	NJ	Pulmonary Disease Physician	$482.8K	$0
Courtney Stull	CA	Rheumatology Physician	$446.6K	$360

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Institute For Dermatopathology, Inc.	PA	Clinical Medical Laboratory	$8.3M	$635.6K
Premier Orthopaedic And Sports Medicine Associates, Ltd	PA	Orthopaedic Surgery Physician	$0	$7.1M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$5.5M
Kimberly Kubek	PA	Diagnostic Radiology Physician	$433.6K	$0
Elizabeth Coch Benstock	PA	Dermatology Physician	$283.1K	$0
Pennsylvania Cvs Pharmacy, L.L.C.	PA	Pharmacy	$267.7K	$0
Tricia Beatty	PA	Sports Medicine (Family Medicine) Physician	$234K	$0
Robert Elliott	PA	Neurological Surgery Physician	$158.6K	$0
Allen Harris	PA	Family Medicine Physician	$125K	$0
Renee Freilich	PA	Adult Psychiatric/Mental Health Clinical Nurse Specialist	$113.2K	$0

Main Line Healthcare — Billing Profile & Reimbursement Data

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Main Line Healthcare — 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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