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

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

Andrew Kaplan (NPI 1053341420)

Field	Value
Entity Type	Individual
Organization	Andrew Kaplan
Address	6 San Remo Dr.
City	S. Burlington
State	VT
ZIP	05403
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	July 3, 2006

Payer Source	Total Paid
Medicare	$8.6K
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
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	90	$30	$2.9K
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…	40	$50	$1.9K
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…	20	$70	$1.7K
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	$40	$960
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,…	30	$20	$750
20605	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…	20	$30	$420

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. Vermont Distribution

Andrew Kaplan — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	821	960	90	$70	$10.6K
99213	678	910	80	$50	$6.7K
20610	30	80	60	$30	$3K
99203	187	310	30	$60	$2.7K
99212	105	250	30	$30	$1.5K
20605	6	10	30	$30	$990

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seth Frenzen	VT	Orthopaedic Surgery Physician	$45.2K	$0
John Macy	VT	Orthopaedic Surgery Physician	$25.5K	$0

Andrew Kaplan — Billing Profile & Reimbursement Data

Sign up for Andrew Kaplan — Billing Profile & Reimbursement Data policy alerts

Andrew Kaplan — Billing Profile & Reimbursement Data

Sign up for Andrew Kaplan — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References