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

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

Medstar Urgent Care LLC (NPI 1942623319)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medstar Urgent Care LLC
Address	6317 York Rd
City	Baltimore
State	MD
ZIP	21212
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	January 21, 2014

Payer Source	Total Paid
Medicaid	$49.1M
Medicare	$0

This entity is effectively a Medicaid-focused operator: there is no Medicare billing on file while reported Medicaid revenue totals $49.1M, indicating the provider’s commercial/public payer mix is highly concentrated on Medicaid rather than Medicare. Analysts should treat the profile as single-payer dominated when benchmarking utilization and revenue.

Revenue is heavily concentrated in a small set of outpatient evaluation-and-management codes: the top three Medicaid codes (99214, 99204, 99213) account for 70.6% of this provider’s total Medicaid revenue. Those codes individually contribute $18.9M (99214, 38.6%), $7.9M (99204, 16.0%), and $7.8M (99213, 16.0%), signaling that E/M encounters drive the majority of billings.

The code mix and volumes are consistent with an urgent care clinic model: 99214, 99204, and 99213 reflect high-volume established- and new-patient outpatient visits with moderate-to-moderate-high medical decision making and extended visit times. Coupled with the provider taxonomy listed as Urgent Care Clinic/Center, the pattern suggests operations focused on front-line ambulatory care and same-day episodic visits rather than longitudinal specialty care.

This provider is a statewide volume leader for several E/M codes: 99214 ranks #5 of 3,673 providers in-state (100th percentile; labeled an "extreme outlier"), 99204 ranks #2 of 934 providers (100th percentile; "extreme outlier"), and 99213 ranks #13 of 3,275 providers (100th percentile; "extreme outlier"). These rankings indicate this entity is a dominant Medicaid provider for outpatient E/M services in Maryland relative to peers.

In addition to E/M visits, the provider reports very high diagnostic testing volumes consistent with urgent care workflows and pandemic-era screening: 87426 appears with 103.4K claims and $3.1M revenue (6.3%), 87635 with 54.8K claims and $1.6M revenue (3.3%), and 87804 with 75.4K claims and $754.2K revenue (1.5%). Many of these lab codes are described as "extreme outlier" or top-ranked in-state (for example, 87635 ranks #2 of 203 providers, 87426 ranks #3 of 252 providers), showing the provider handles large volumes of SARS–CoV–2, influenza, and strep testing.

The provider’s lab/testing footprint extends beyond COVID-specific assays to include high volumes of rapid antigen and molecular tests for common respiratory pathogens: 87880 (Strep A immunoassay) has 79.7K claims and $478.2K revenue (1.0%) and 87651 (Strep A NAAT) has 16.8K claims and $436.6K revenue (0.9%), with both codes ranking at or near the top in-state (87880 rank #2 of 377; 87651 rank #1 of 67; both 100th percentile labeled as "extreme outlier"). This breadth of testing indicates ancillary revenue streams that complement the high-volume E/M practice.

Although high-complexity and moderate-complexity E/M codes dominate, lower-intensity visit codes are present but contribute a much smaller share: 99215 appears with 15.7K claims and $738.4K revenue (1.5%), 99212 with 8.8K claims and $406.4K revenue (0.8%), and 99211 with 1.6K claims and $63.6K revenue (0.1%). The distribution suggests visit-level intensity skews toward mid-level encounters rather than being concentrated in only the lowest-complexity visits.

The provider has an established operating history in Maryland with NPI enumeration dated 2014-01-21 (~12 years ago). Coupled with $49.1M in lifetime Medicaid revenue and repeated top-state rankings across multiple E/M and lab codes, the data indicate a sustained, high-volume urgent care presence in the state rather than a transient or nascent operation.

Medicaid: Complete Services Breakdown

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

58 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…	191,190	$100	$18.9M
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…	72,100	$110	$7.9M
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…	97,980	$80	$7.8M
99203	The provider sees a new 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 provider…	54,340	$80	$4.4M
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	103,370	$30	$3.1M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	54,760	$30	$1.6M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	15,030	$100	$1.5M
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.	75,420	$10	$754.2K
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…	15,710	$50	$738.4K
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.	79,700	$10	$478.2K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Medstar Urgent Care LLC — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	57	70	7,000	$120	$1.8M
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…	5	3,670	680	$90	$310K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	2	60	250	$100	$299.5K
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…	13	3,280	610	$80	$296.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	15	40	150	$90	$192.4K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	4	30	120	$50	$132.4K
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…	3	1,000	200	$120	$96.3K
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…	2	930	110	$100	$90.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	3	250	320	$30	$82.2K
99203	The provider sees a new 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 provider…	1	730	110	$70	$81.9K

Showing 1–10 of 58

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saba Ucbamichael	MD	Family Nurse Practitioner	$74.3K	$0
Seona Lisse	DC	Physician Assistant	$55.4K	$0
Millicent Animley	DC	Family Nurse Practitioner	$42.9K	$0
Darryl Bines	VA	Physician Assistant	$36.2K	$0
Lauren Ruehle	WV	Family Nurse Practitioner	$32.7K	$0
Kathryn Jenkins	AE (Armed Forces Europe)	Physician Assistant	$32.6K	$0
Valerie Fitton	DC	Physician Assistant	$27K	$0
Courtney Taylor	VA	Physician Assistant	$24.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Balance Point Wellness	MD	Professional Counselor	$0	$18.5M
Rl Changing Lives One At A Time LLC	MD	Community/Behavioral Health Agency	$0	$15.7M
Glenwood Life-counseling Center Inc	MD	Methadone Clinic	$361.5K	$9.5M
Advanced Behavioral Health, Inc.	MD	Child & Adolescent Psychiatry Physician	$0	$8.9M
No One Left Behind Changing Lives	MD	Community/Behavioral Health Agency	$0	$6.7M
Vision Healthcare Services,inc.	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.4M
Changing Lives Together, LLC	MD	Community/Behavioral Health Agency	$0	$6.3M
Transformation Healthcare Inc.	MD	Substance Abuse Rehabilitation Facility	$0	$5.5M
Enriching Lives Support Services Inc	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$4.5M
House Of Change Behavioral Health Center	MD	Substance Abuse Rehabilitation Facility	$0	$4.4M

Medstar Urgent Care LLC — Billing Profile & Reimbursement Data

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Medstar Urgent Care LLC — 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