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

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

Fairbanks Urology (NPI 1043727878)

Fairbanks Urology is a urology physician provider located in Fairbanks, Alaska. This profile covers 0 Medicare and 12 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	Fairbanks Urology
Address	1211 Cushman St
City	Fairbanks
State	AK
ZIP	99701
Taxonomy	Urology Physician
NPI Enumerated	January 2, 2018

Payer Source	Total Paid
Medicaid	$197K
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	1,630	$90	$138.9K
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…	560	$70	$36.3K
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…	130	$110	$14.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$140	$5.2K
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…	20	$90	$1.6K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	10	$20	$340
84402	The lab analyst performs a test to measure free testosterone, typically in patient serum.	20	$10	$180
84270	The lab analyst performs a test to measure sex hormone binding globulin, or SHBG, typically in patient blood.	20	$10	$160
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	20	$1	$80
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	20	$1	$40

Showing 1–10 of 12

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Fairbanks Urology — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	257	490	680	$260	$1M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	62	70	570	$110	$829.4K
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…	126	440	580	$170	$458.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	59	60	1,190	$20	$146.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	98	130	130	$190	$99.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	75	130	250	$20	$83.8K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	17	30	340	$30	$68.2K
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…	113	130	110	$120	$53.5K
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…	29	100	50	$180	$33.7K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	3	10	20	$30	$5.1K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Sharp	AK	Urology Physician	$356K	$0
Tony Nimeh	AK	Urology Physician	$271.6K	$0
Paul Patton	AK	Surgical Physician Assistant	$32K	$0
Samantha Barraclough	AL	Physician Assistant	$7.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$107.5M
Fairbanks Memorial Hospital, LLC	AK	General Acute Care Hospital	$0	$83.6M
Fairbanks Resource Agency Inc	AK	Community/Behavioral Health Agency	$0	$48M
Presbyterian Hospitality House	AK	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$34.9M
Fairbanks Native Association	AK	Substance Abuse Rehabilitation Facility	$0	$32.6M
Tanana Chiefs Confenerce	AK	Transportation Broker	$0	$24.1M
Tanana Chiefs Conference	AK	Community/Behavioral Health Agency	$0	$17M
Tanana Chiefs Conference	AK	Multi-Specialty Clinic/Center	$0	$16.3M
Restore LLC	AK	Substance Use Disorder Rehabilitation Clinic/Center	$0	$16.3M
Tanana Valley Clinic LLC	AK	Multi-Specialty Clinic/Center	$0	$15.2M

Fairbanks Urology — Billing Profile & Reimbursement Data

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Fairbanks Urology — 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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