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

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

The Gastroenterology Clinic & Endoscopy Center Inc (NPI 1952497117)

The Gastroenterology Clinic & Endoscopy Center Inc is a gastroenterology physician provider located in Warren, Ohio. This profile covers 0 Medicare and 32 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	The Gastroenterology Clinic & Endoscopy Center Inc
Address	1622 E Market St
City	Warren
State	OH
ZIP	44483
Taxonomy	Gastroenterology Physician
NPI Enumerated	October 5, 2006

Payer Source	Total Paid
Medicaid	$7.2M
Medicare	$0

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	17,050	$100	$1.7M
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.	12,040	$130	$1.5M
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…	27,380	$30	$903.6K
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	9,610	$70	$653.7K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	3,620	$170	$611.9K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	7,270	$60	$421.8K
00811	The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to…	5,930	$70	$403.3K
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…	5,100	$50	$239.7K
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…	800	$160	$124.5K
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…	6,810	$20	$115.7K

Showing 1–10 of 32

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

The Gastroenterology Clinic & Endoscopy Center Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	772	4,510	500	$60	$377.8K
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…	266	5,080	560	$40	$323.9K
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.	2	280	570	$250	$276.5K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	28	340	1,220	$30	$186.7K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	2	180	190	$320	$139.3K
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…	419	600	480	$30	$132.5K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	32	150	140	$450	$129.5K
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…	731	1,030	180	$90	$127K
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…	168	920	640	$20	$114.7K
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…	5	100	60	$370	$72.3K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marion Area Physicians LLC	OH	Internal Medicine Physician	$0	$15.7M
Nadeem Malik	OH	Anatomic Pathology & Clinical Pathology Physician	$249.5K	$79.3K
Sanjiv Khetarpal	OH	Gastroenterology Physician	$97.7K	$0
Milan Dodig	OH	Gastroenterology Physician	$83K	$0
John Weippert	OH	Internal Medicine Physician	$62K	$0
Vivian Chidi	OR	Internal Medicine Physician	$57K	$0
Adel Youssef	OH	Specialist	$28.8K	$22.2K
Charlene White-lowery	OH	Certified Registered Nurse Anesthetist	$42.4K	$5.3K
Kevin Castillo	NC	Gastroenterology Physician	$45.8K	$0
Christine Freund	OH	Certified Registered Nurse Anesthetist	$40.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steward Trumbull Memorial Hospital, Inc.	OH	General Acute Care Hospital	$0	$16.5M
Warren Gastro Endoscopy Ctr Inc	OH	Ambulatory Surgical Clinic/Center	$288.2K	$1.8M
Fernando Chaves	OH	Pulmonary Disease Physician	$257.5K	$5.2K
Ehab Sargious	OH	Specialist	$74.2K	$102.9K
St. Mina Interventional Pain Center, Inc	OH	Ambulatory Surgical Clinic/Center	$158.6K	$0
Richard Hart	OH	Family Medicine Physician	$124.8K	$1.4K
Badi Altawil	OH	Internal Medicine Physician	$105.2K	$10.1K
Linda Olmstead	OH	Anatomic Pathology & Clinical Pathology Physician	$28.2K	$68K
Zachary Veres	OH	Family Medicine Physician	$82.8K	$0
Edward Myers	OH	Family Medicine Physician	$76.8K	$0

The Gastroenterology Clinic & Endoscopy Center Inc — Billing Profile & Reimbursement Data

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The Gastroenterology Clinic & Endoscopy Center Inc — 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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