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.

Gastroenterology Health Partners, PLLC (NPI 1982963872)

Gastroenterology Health Partners, PLLC is a gastroenterology physician provider located in Lousiville, Kentucky. This profile covers 0 Medicare and 23 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	Gastroenterology Health Partners, PLLC
Address	1941 Bishop Ln
City	Lousiville
State	KY
ZIP	40218
Taxonomy	Gastroenterology Physician
NPI Enumerated	May 11, 2012

Payer Source	Total Paid
Medicaid	$3.1M
Medicare	$0

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

23 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…	8,910	$90	$837.9K
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…	17,250	$40	$689.9K
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.	5,160	$70	$356.2K
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…	11,790	$30	$353.6K
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…	8,500	$30	$212.6K
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…	1,260	$120	$144.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,510	$50	$120.5K
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…	1,350	$80	$104.2K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	1,230	$50	$56.5K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	1,200	$40	$50.4K

Showing 1–10 of 23

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

Gastroenterology Health Partners, PLLC — 3 of 23 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

23 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.	14	170	1,300	$230	$441K
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…	31	130	2,450	$60	$382.4K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	59	80	260	$270	$358.5K
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…	507	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…	122	2,460	580	$40	$245K
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…	53	120	300	$320	$215.2K
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…	83	470	770	$20	$188.2K
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…	17	110	230	$340	$175.7K
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…	122	290	520	$30	$156.6K
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…	67	90	170	$400	$145.8K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Stapp	IN	Anatomic Pathology & Clinical Pathology Physician	$355.2K	$0
Abdul Jabbar	IN	Gastroenterology Physician	$297K	$0
James Strobel	IN	Gastroenterology Physician	$292.2K	$0
Jonathan Obert	IN	Gastroenterology Physician	$225.6K	$0
Steven Harrell	IN	Gastroenterology Physician	$222.9K	$0
Matthew Mccollough	IN	Gastroenterology Physician	$151.5K	$0
Laszlo Makk	KY	Gastroenterology Physician	$150.9K	$0
David Rankin	IN	Anatomic Pathology & Clinical Pathology Physician	$137.7K	$0
James Rizzo	IN	Anatomic Pathology & Clinical Pathology Physician	$100.4K	$0
Robert Luckett	IN	Gastroenterology Physician	$96.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Freedom Senior Share, LLC	KY	Adult Day Care Clinic/Center	$0	$142.4M
Keystone Services, Inc Dba	KY	Adult Companion	$0	$55.5M
Breaking Barriers Of Ky LLC	KY	Community/Behavioral Health Agency	$0	$15.3M
Alternative Services For Individuals	KY	Adult Mental Health Clinic/Center	$0	$12.3M
Osting Individual And Family Services Inc	KY	Community/Behavioral Health Agency	$0	$9.6M
Bluegrass Counseling Associates	KY	Clinical Social Worker	$0	$9.4M
Kentucky Case Management, LLC	KY	Case Management Agency	$0	$9.3M
Meeting Challenges LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.4M
Active Day Ky, Inc.	KY	Developmental Disabilities Clinic/Center	$0	$6.1M
Board Of Education Of Jefferson County Kentucky	KY	Local Education Agency (LEA)	$0	$4.9M

Gastroenterology Health Partners, PLLC — Billing Profile & Reimbursement Data

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Gastroenterology Health Partners, PLLC — 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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