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.

Primary Care Centers Of Eastern Kentucky, LLC (NPI 1942275805)

Field	Value
Entity Type	Organization
Organization	Primary Care Centers Of Eastern Kentucky, LLC
Address	101 Town And Country Ln
City	Hazard
State	KY
ZIP	41701
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	February 22, 2006

Payer Source	Total Paid
Medicaid	$26.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

188 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…	382,430	$30	$11.9M
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.	95,900	$30	$2.4M
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,…	98,580	$20	$2.4M
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.	138,670	$10	$1.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	28,470	$30	$854.1K
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.	11,400	$50	$524.4K
D0150	Comprehensive oral evaluation – new or established patient	12,820	$40	$448.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	7,480	$40	$321.4K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	11,830	$30	$319.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	8,080	$40	$299K

Showing 1–10 of 188

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

Primary Care Centers Of Eastern Kentucky, LLC — 15 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

188 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	86	340	2,700	$40	$673.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	146	160	2,900	$110	$610.8K
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.	60	200	16,730	$10	$365.9K
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…	6	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…	1,272	2,460	580	$40	$245K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	39	40	180	$110	$217.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	27	470	770	$20	$188.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	57	230	720	$60	$180.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	56	260	540	$70	$176.6K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	220	230	350	$100	$162.2K

Showing 1–10 of 188

Related Providers

Other providers that share a Tax Identification Number (TIN) with Primary Care Centers Of Eastern Kentucky, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primary Care Centers Of Eastern Kentucky, LLC	KY	Rural Health Clinic/Center	$0	$3.6M
Robetta Baker	KY	Family Nurse Practitioner	$181.6K	$1.4M
Ionut Stefanescu Sturz	KY	Internal Medicine Physician	$122.9K	$512.8K
Brianna Cornett	KY	Nurse Practitioner	$4.2K	$156.5K
Makenzie Bentley	KY	Family Nurse Practitioner	$17.7K	$0
Christie Herald	KY	Family Nurse Practitioner	$4.3K	$0
Crystal Gibson	KY	Physician Assistant	$80	$0

Nearby Providers

Other providers in the same ZIP code as Primary Care Centers Of Eastern Kentucky, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky River Community Care, Inc	KY	Specialist	$0	$109.1M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$107.9M
Kentucky River Community Care, Inc	KY	Mental Health Counselor	$0	$104M
Kentucky River Area Dev Dist	KY	Supports Brokerage Agency	$0	$43.4M
Soaring Potentials Lllp	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.4M
Bhg Xxvi, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$493.7K	$16.1M
Southern Medical Partners, LLC	KY	Emergency Medicine Physician	$0	$15.6M
Dungarvin Kentucky, LLC - Hazard	KY	Developmentally Disabled Services Day Training Agency	$0	$10.1M
Quantum Healthcare Associates Inc	KY	General Practice Physician	$0	$9.1M
Community Alternatives Kentucky, Inc.	KY	Case Management Agency	$0	$7.6M

Primary Care Centers Of Eastern Kentucky, LLC — Billing Profile & Reimbursement Data

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Primary Care Centers Of Eastern Kentucky, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References