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

Why is the Medicaid comparison limited to Wisconsin 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. Wisconsin (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 Heaberlin (NPI 1043604960)

Field	Value
Entity Type	Individual
Organization	James Heaberlin
Address	2999 N Mayfair Rd
City	Wauwatosa
State	WI
ZIP	53222
Taxonomy	Orthopaedic Hand Surgery Physician
NPI Enumerated	March 28, 2015

Payer Source	Total Paid
Medicare	$15.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 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…	100	$60	$5.9K
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…	60	$70	$4.6K
25600	The provider treats a fracture of the wrist end of the radius, one of the bones in the forearm, in which the fracture fragment displaces upward or downward, in a closed procedure. The growth plate at…	10	$240	$3.1K
20550	Aponeurosis is an abnormal sheet like extension of the tendon. Injection of a tendon or ligament is the medical therapeutic procedure to reduce the aponeurosis formation.	40	$30	$1.2K
20600	In this procedure, the provider inserts a needle through the skin of a patient and into a small joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	20	$30	$590
Q4010	Cast supplies, short arm cast, adult (11 years +), fiberglass	10	$20	$230
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	150	$1	$150

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

James Heaberlin — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	2,540	9,380	60	$50	$4.7K
25600	1	10	10	$230	$2.7K
99203	428	2,820	30	$60	$2.4K
20550	53	150	30	$30	$1.2K
20600	55	80	20	$30	$920
Q4010	4	10	20	$20	$330
J3301	295	600	150	$1	$240

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Speciality Screening LLC	WI	Clinical Medical Laboratory	$0	$10.8M
Genetox, LLC	WI	Clinical Medical Laboratory	$0	$6.5M
Tracy Pritzl	WI	Clinical Psychologist	$0	$4.5M
West Grove Clinic, Sc	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.8M
Maria Amarante	WI	Professional Counselor	$0	$3.6M
Elizabeth Moberg-wolff	WI	Pediatric Rehabilitation Medicine Physician	$49.2K	$2.7M
Fresenius Medical Care Midwest Dialysis, LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.5M
Children's Medical Group	WI	Pediatrics Physician	$0	$2.1M
Milwaukee Internal Medicine Associates Inc	WI	Multi-Specialty Clinic/Center	$0	$2M
Wellpoint Care Network	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2M

James Heaberlin — Billing Profile & Reimbursement Data

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James Heaberlin — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References