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

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

Sephalie Patel (NPI 1033370671)

Field	Value
Entity Type	Individual
Organization	Sephalie Patel
Address	12902 Usf Magnolia Drive Wcb-anest
City	Tampa
State	FL
ZIP	33612
Taxonomy	Anesthesiology Physician
NPI Enumerated	June 17, 2008

Payer Source	Total Paid
Medicare	$13.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
00862	The provider performs anesthesia services for an extraperitoneal procedure in the lower abdomen, including the urinary tract; renal procedures, including upper one third of ureter, or donor…	30	$200	$5.5K
00864	The provider performs anesthesia services for an extraperitoneal procedure in the lower abdomen, including urinary tract; total cystectomy.	10	$280	$3.6K
01922	The provider performs anesthesia services for a patient undergoing non–invasive imaging or radiation therapy.	10	$110	$1.6K
00912	The provider performs anesthesia services for a patient undergoing excision of one or more tumors within the bladder performed through the urethra, which is the opening for the outflow of urine.	10	$80	$1.1K
36620	In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood…	20	$40	$740
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	10	$60	$670

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Sephalie Patel — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
00864	1	10	10	$280	$3.6K
00862	1	10	10	$200	$3.4K
00731	2,708	2,890	20	$90	$2.8K
00912	23	40	20	$110	$2.5K
01922	471	780	20	$120	$2.4K
36620	435	920	20	$40	$940

Sephalie Patel — Billing Profile & Reimbursement Data

Sign up for Sephalie Patel — Billing Profile & Reimbursement Data policy alerts

Sephalie Patel — Billing Profile & Reimbursement Data

Sign up for Sephalie Patel — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References