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

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

David James (NPI 1033398771)

Field	Value
Entity Type	Individual
Organization	David James
Address	3535 Berrywood Dr
City	Columbia
State	MO
ZIP	65201
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 30, 2007

Payer Source	Total Paid
Medicare	$180K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	500	$80	$39.7K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	340	$110	$37.7K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	270	$130	$35.2K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	290	$70	$21.3K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	210	$80	$16.1K
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…	190	$50	$9.6K
99316	The provider sees a patient for nursing facility discharge management requiring more than 30 minutes.	90	$90	$8.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	$110	$6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	40	$150	$6K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

David James — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	212	520	210	$70	$28.3K
99310	18	200	80	$100	$14K
99233	117	2,660	70	$90	$12.1K
99306	14	200	50	$130	$11.6K
99291	841	1,480	50	$160	$11.3K
99232	1,256	4,320	90	$60	$10.8K
99223	1,002	2,720	40	$130	$8.2K
99239	73	1,320	70	$90	$7.5K
99316	8	80	30	$90	$3.7K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Thomas	MO	Diagnostic Radiology Physician	$249.4K	$735.2K
Terrence Chambers	IN	Diagnostic Radiology Physician	$152.4K	$700.7K
Justin Hodge	MO	Diagnostic Radiology Physician	$111.9K	$735.6K
Linda Armstrong	GA	Diagnostic Radiology Physician	$643.9K	$175.1K
Christopher Russell	MO	Diagnostic Radiology Physician	$126K	$504K
Robbie Shoots	NM	Diagnostic Radiology Physician	$597.6K	$10.1K
Frederick Harris	MO	Diagnostic Radiology Physician	$117.5K	$467.5K
James Borders	MO	Diagnostic Radiology Physician	$423.1K	$108.8K
Bradley Anderson	MO	Gastroenterology Physician	$510.4K	$0
Derek Fimmen	CO	Diagnostic Radiology Physician	$140.8K	$366.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Woodhaven	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$88.3M
Palmer's Home Care, LLC	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$82.3M
Oats, Inc.	MO	Non-emergency Medical Transport (VAN)	$0	$23.4M
Independent Living Center Of Mid-missouri Inc.	MO	Specialist	$0	$14.2M
Ch Allied Services, Inc.	MO	General Acute Care Hospital	$0	$8.6M
Central Missouri Area Agency On Aging	MO	Voluntary or Charitable Agency	$0	$8.4M
Life Christain Outreach	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.1M
Surgical Center At Columbia Orthopaedic Group LLC	MO	Ambulatory Surgical Clinic/Center	$6.2M	$0
Mid-missouri Supported Living	MO	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$5.3M
Woodhaven Learning Center	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$5.1M

David James — Billing Profile & Reimbursement Data

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David James — 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