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

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

Bertram D Kaplan Md PLLC (NPI 1023410941)

Bertram D Kaplan Md PLLC is a dermatology physician provider located in Memphis, Tennessee. This profile covers 0 Medicare and 18 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	Bertram D Kaplan Md PLLC
Address	6401 Poplar Ave Ste 405
City	Memphis
State	TN
ZIP	38119
Taxonomy	Dermatology Physician
NPI Enumerated	September 23, 2014

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

18 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…	31,700	$30	$1.1M
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…	4,860	$60	$281.8K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	2,690	$90	$250K
11901	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	5,060	$30	$167.1K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	1,490	$60	$82K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	1,440	$50	$73.6K
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…	4,970	$10	$54.7K
10040	The provider performs extractions to treat skin lesions such as milia, comedones, cysts, or pustules. The procedure may involve surgically opening the lesion, draining it, or removing it entirely.	480	$70	$34.8K
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…	580	$60	$33.1K
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,…	1,220	$20	$24.4K

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

Bertram D Kaplan Md PLLC — 5 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

18 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…	1,920	3,760	610	$40	$202.3K
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…	133	4,050	620	$30	$183.9K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	8	70	90	$90	$59.9K
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…	45	1,240	120	$60	$53.1K
11901	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	1	10	120	$30	$46.6K
11900	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	3	10	30	$20	$40.8K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	6	50	180	$50	$32.6K
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,…	209	1,170	170	$20	$23.8K
10040	The provider performs extractions to treat skin lesions such as milia, comedones, cysts, or pustules. The procedure may involve surgically opening the lesion, draining it, or removing it entirely.	1	10	270	$70	$19.2K
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…	103	1,270	470	$10	$19.2K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ut Medical Group Inc	TN	Multi-Specialty Clinic/Center	$0	$53.1M
Amisub (sfh), Inc.	TN	General Acute Care Hospital	$0	$20.2M
Maxim Healthcare Services, Inc.	TN	Home Health Agency	$0	$18.5M
Mid-south Maternal Fetal Medicine PC	TN	Maternal & Fetal Medicine Physician	$0	$8.1M
Elect Home Care, LLC	TN	In Home Supportive Care Agency	$0	$7.6M
First Choice Community Services, Inc	TN	In Home Supportive Care Agency	$0	$7.5M
Tennessee Emergency Physicians, PLLC	TN	Emergency Medicine Physician	$0	$6.3M
Dar Salud Care PLLC	TN	Family Medicine Physician	$0	$5.2M
Silver Angels Of Tennessee - Shelby, LLC	TN	In Home Supportive Care Agency	$0	$5.1M
Abundant Care LLC	TN	In Home Supportive Care Agency	$0	$4.1M

Bertram D Kaplan Md PLLC — Billing Profile & Reimbursement Data

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Bertram D Kaplan Md 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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