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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Gastrointestinal Associates, PC (NPI 1942261706)

Gastrointestinal Associates, PC is a gastroenterology physician provider located in Washington, District of Columbia. This profile covers 0 Medicare and 11 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	Gastrointestinal Associates, PC
Address	1160 Varnum St Ne
City	Washington
State	DC
ZIP	20017
Taxonomy	Gastroenterology Physician
NPI Enumerated	March 31, 2006

Payer Source	Total Paid
Medicaid	$292.2K
Medicare	$0

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

11 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…	2,610	$50	$120.2K
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…	470	$120	$54.8K
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…	170	$200	$33.3K
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…	220	$130	$28.9K
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…	540	$50	$27.5K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	90	$140	$11.6K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	60	$150	$8.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	90	$70	$5.9K
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,…	20	$40	$860
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…	10	$30	$440

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

Gastrointestinal Associates, PC — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	16	20	310	$530	$605.1K
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,…	113	130	290	$140	$579.2K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	11	10	180	$790	$490.4K
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…	171	310	750	$70	$321.6K
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…	82	320	620	$50	$313.6K
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…	37	40	300	$100	$193.8K
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…	6	20	100	$140	$192.8K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	5	10	70	$170	$151.1K
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…	32	80	100	$120	$131.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	20	20	310	$30	$114.5K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
My Own Place, Inc.	DC	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$48.7M
Anchor Mental Health Association	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$22M
Hsc Home Care, LLC	DC	Home Health Agency	$0	$14.7M
Providence Health Services Inc	DC	Family Medicine Physician	$0	$13.4M
Providence Hospital	DC	General Acute Care Hospital	$0	$12.2M
American Health Care Services Inc	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.3M
Hospital For Sick Children	DC	Special Hospital	$0	$4.7M
United Cerebral Palsy Of Washington & No. Virginia, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Gerald Family Care	DC	Family Medicine Physician	$0	$3.2M
Cheryl Lee	DC	Dentist	$0	$2.5M

Gastrointestinal Associates, PC — Billing Profile & Reimbursement Data

Sign up for Gastrointestinal Associates, PC — Billing Profile & Reimbursement Data policy alerts

Gastrointestinal Associates, PC — Billing Profile & Reimbursement Data

Sign up for Gastrointestinal Associates, PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stuart Horwitz	DC	Gastroenterology Physician	$165.8K	$355.9K
Gary Thompson	DC	Gastroenterology Physician	$174.2K	$0
Danny Shearer	DC	Gastroenterology Physician	$165.1K	$0