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

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

James Gross (NPI 1023082203)

Field	Value
Entity Type	Individual
Organization	James Gross
Address	118 S 12th St
City	Mount Vernon
State	WA
ZIP	98274
Taxonomy	Otolaryngology Physician
NPI Enumerated	February 15, 2006

Payer Source	Total Paid
Medicare	$72.9K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

17 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…	330	$60	$20.1K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	910	$10	$10.9K
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…	70	$120	$8.6K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	1,000	$10	$6K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	190	$30	$5.5K
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…	50	$70	$3.3K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,100	$1	$3.3K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	330	$10	$2.7K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	380	$10	$2.6K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	30	$90	$2.6K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

James Gross — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	18	40	700	$10	$16.9K
99214	10,188	10,860	100	$80	$13.6K
17000	385	510	160	$40	$8.5K
31231	112	130	40	$130	$7.8K
99213	647	9,690	60	$60	$6.5K
99204	814	4,750	30	$110	$5.2K
95024	3	10	370	$10	$4.7K
31575	113	180	40	$90	$4.6K
17003	406	440	550	$1	$4K
95004	23	60	870	$1	$3.7K

Showing 1–10 of 17

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Public Hospital Dist No 1 Skagit	WA	General Acute Care Hospital	$0	$88.6M
Public Hospital Dist No 1 Skagit	WA	General Practice Physician	$0	$24.7M
Public Hospital Dist No 1 Skagit	WA	General Acute Care Hospital	$0	$17.2M
Yoshio Inoue	WA	Medical Oncology Physician	$1.3M	$0
Daryl Sudasena	WA	Interventional Cardiology Physician	$380.6K	$0
Stacia Smith	WA	Orthopaedic Surgery Physician	$324.7K	$0
Ramy Hanna	WA	Clinical Cardiac Electrophysiology Physician	$213.9K	$0
Richard Lin	WA	Dermatology Physician	$195.1K	$0
Bhrigu Parmar	WA	Cardiovascular Disease Physician	$177.2K	$0
Murad Yunusov	WA	Hospitalist Physician	$171.9K	$0

Nearby Providers

Other providers in the same ZIP code as James Gross, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Skagit Pediatrics, LLP	WA	Pediatrics Physician	$0	$6M
Eye Associates Surgery Center Inc	WA	Ambulatory Surgical Clinic/Center	$839.9K	$44.4K
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$793.8K	$0
Dawei Lu	WA	Orthopaedic Surgery of the Spine Physician	$264.1K	$0
Navdeep Dhaliwal	WA	Internal Medicine Physician	$248.8K	$12.2K
Carlindo Da Reitz Pereira	WA	Ophthalmology Physician	$230.4K	$0
Michal Whiton	WA	Radiation Oncology Physician	$229.5K	$0
Ernesto Golez	WA	Ophthalmology Physician	$203.2K	$0
Kiran Chaturvedi	WA	Anatomic Pathology & Clinical Pathology Physician	$165.4K	$0
Oscar Briseno	WA	Cardiovascular Disease Physician	$162.7K	$0

James Gross — Billing Profile & Reimbursement Data

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James Gross — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References