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

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

Springs Medical Associates, PC (NPI 1982013082)

Springs Medical Associates, PC is a family medicine physician provider located in Colorado Springs, Colorado. This profile covers 0 Medicare and 65 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	Springs Medical Associates, PC
Address	155 Printers Pkwy Ste 230
City	Colorado Springs
State	CO
ZIP	80910
Taxonomy	Family Medicine Physician
NPI Enumerated	August 4, 2014

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

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

65 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…	22,630	$50	$1M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	3,470	$130	$457.4K
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…	2,650	$70	$185.4K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	11,100	$10	$122.1K
83992	The lab analyst measures the level of this drug, phencyclidine, typically in a urine or blood sample. This very potent street drug is a common drug of abuse.	4,090	$20	$73.5K
80348	The lab analyst measures the amount of or detects the presence of buprenorphine in a patient specimen. Buprenorphine is a drug used to treat opioid addiction, to control acute pain in individuals who…	4,270	$20	$68.4K
80356	The lab analyst measures the amount of or detects the presence of heroin metabolite in the patient specimen.	4,270	$20	$68.4K
80346	The lab analyst measures the amount of or detects the presence of one to twelve benzodiazepines, which are tranquilizers, in a patient specimen.	4,270	$20	$68.4K
80353	The lab analyst measures the amount of or detects the presence of cocaine in the patient specimen.	4,270	$20	$68.4K
80354	The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen.	4,270	$20	$68.4K

Showing 1–10 of 65

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Springs Medical Associates, PC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

65 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	88	2,520	330	$100	$352K
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…	557	2,630	430	$90	$268.2K
80357	The lab analyst measures the amount of or detects the presence of ketamine and norketamine in the patient specimen.	6	10	3,570	$20	$122.5K
80360	The lab analyst measures the amount of or detects the presence of methylphenidate, which is a central nervous system stimulant that treats attention deficit disorders, in the patient specimen.	6	10	3,630	$20	$119.4K
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,…	112	690	140	$90	$118.4K
80332	The lab analyst measures the amount of or detects the presence of one or two serotonergic antidepressants, which are psychiatric medications, in a patient specimen.	3	10	630	$20	$117.3K
80356	The lab analyst measures the amount of or detects the presence of heroin metabolite in the patient specimen.	7	20	2,810	$20	$114.2K
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…	43	100	380	$20	$107.6K
80368	The lab analyst measures the amount of or detects the presence of non–benzodiazepine sedative hypnotics in a patient specimen.	5	10	2,700	$20	$103.9K
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.	14	90	800	$30	$103.7K

Showing 1–10 of 65

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$37.8M
Kaaum Enterprises	CO	Developmental Disabilities Clinic/Center	$0	$34.3M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$28.6M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$19.9M
Peak Vista Community Health Centers	CO	Federally Qualified Health Center (FQHC)	$0	$12.4M
Diversus Health Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.2M
Summit Primary Care	CO	Family Medicine Physician	$0	$10.3M
Diversus Health Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.5M
Your Choice Residential	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.5M
Kids Crossing	CO	Voluntary or Charitable Agency	$0	$8M

Springs Medical Associates, PC — 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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