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.

Ideal Option, PLLC (NPI 1992226310)

Field	Value
Entity Type	Organization
Organization	Ideal Option, PLLC
Address	265 Mill St Ste 100
City	Hagerstown
State	MD
ZIP	21740
Taxonomy	Addiction Medicine (Family Medicine) Physician
NPI Enumerated	July 6, 2017

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 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…	32,720	$120	$3.9M
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.	48,500	$50	$2.5M
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…	3,210	$190	$594.6K
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…	4,590	$80	$348.5K
99205	The provider sees a new 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 provider…	360	$210	$73.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	100	$20	$1.5K
Q3014	Telehealth originating site facility fee	10	$20	$340

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

Ideal Option, PLLC — 2 of 7 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

7 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.	6	160	980	$50	$387.6K
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…	39	3,670	680	$90	$310K
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…	583	3,280	610	$80	$296.1K
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…	54	1,000	200	$120	$96.3K
99205	The provider sees a new 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 provider…	78	530	60	$170	$39.8K
Q3014	Telehealth originating site facility fee	58	60	290	$20	$14.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	205	310	240	$20	$13.3K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ideal Option, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ideal Option, PLLC	WA	Clinic/Center	$0	$259.1M
Ideal Option, PLLC	WA	Clinical Medical Laboratory	$0	$39.2M
Ideal Option, PLLC	MT	Addiction Medicine (Family Medicine) Physician	$0	$3.6M
Ideal Option, PLLC	MT	Addiction Medicine (Family Medicine) Physician	$0	$3.3M
Crm Physicians, LLC	OR	Internal Medicine Physician	$0	$2.1M
Ideal Option, PLLC	MT	Multi-Specialty Clinic/Center	$0	$1.2M
Ideal Option, PLLC	MT	Clinic/Center	$0	$731.9K
Ideal Option, PLLC	MT	Clinic/Center	$0	$703.9K
Ideal Option, PLLC	MT	Clinic/Center	$0	$692.7K
Ideal Option, PLLC	ND	Clinic/Center	$0	$690.9K

Nearby Providers

Other providers in the same ZIP code as Ideal Option, PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr. David M. Vieth 2, P.C.	MD	General Practice Dentistry	$0	$77.8M
Potomac Case Management Services, Inc.	MD	Case Management Agency	$0	$28M
Phoenix Health Center LLC	MD	Methadone Clinic	$507.7K	$21.4M
Awakenings Recovery Center, LLC	MD	Substance Abuse Rehabilitation Facility	$0	$19.8M
Qualitycare Internet, LLP	MD	Mental Health Counselor	$0	$19.4M
Walnut Street Community Health Center, Inc.	MD	Federally Qualified Health Center (FQHC)	$0	$19.3M
Board Of Education Of Washington County	MD	Local Education Agency (LEA)	$0	$19.1M
Center For Pain Management, LLC	MD	Interventional Pain Medicine Physician	$0	$18.9M
Metro Treatment Of Maryland LP	MD	Community/Behavioral Health Agency	$361K	$16.6M
The Western Maryland Counseling Center	MD	Community/Behavioral Health Agency	$0	$16.5M

Ideal Option, PLLC — Billing Profile & Reimbursement Data

Sign up for Ideal Option, PLLC — Billing Profile & Reimbursement Data policy alerts

Ideal Option, PLLC — Billing Profile & Reimbursement Data

Sign up for Ideal Option, PLLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References