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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Edward Frank (NPI 1053426015)

Field	Value
Entity Type	Individual
Organization	Edward Frank
Address	76 Allds St
City	Nashua
State	NH
ZIP	03060
Taxonomy	Dermatology Physician
NPI Enumerated	August 20, 2006

Payer Source	Total Paid
Medicare	$349.2K
Medicaid	$0

Key Findings

Edward Frank is a dermatology physician in Nashua, NH with reported lifetime Medicare revenue of $349.2K and no Medicaid billing on file, making his practice effectively single‑payer from the public program perspective. His NPI shows long tenure, registered 2006-08-20 (~20 years ago), indicating an established local practice footprint rather than a recent entrant.

The provider’s top revenue drivers are procedural dermatology services — specifically Mohs micrographic surgery and high-volume office E/M visits. Code 17311 (Mohs) accounts for $89.4K (25.6% of Medicare revenue) and 17312 accounts for $47.6K (13.6%), while 99213 (office established E/M) contributes $53.6K (15.4%), showing a mix of surgical oncology and outpatient follow-up as the practice’s primary service lines.

Revenue is concentrated: the top 3 Medicare codes by revenue (17311, 99213, 17312) collectively account for 54.6% of this provider’s total Medicare revenue, highlighting dependence on a small set of high-impact services for the majority of public payer receipts. That concentration suggests that changes in reimbursement or referral patterns for Mohs or routine dermatology visits could materially affect Medicare revenue.

Competitive standing for Mohs procedures appears modest relative to national peers. 17311 ranks #1762 of 2969 providers (41th percentile; characterized in the source as "typical, unremarkable volume for this code") and 17312 ranks #1270 of 2770 (54th percentile; typical), indicating the provider performs Mohs at rates near the middle of national Mohs practitioners rather than as a regional leader.

By contrast, the provider is a clear outlier on basic office E/M volume: 99213 ranks #8378 of 457151 providers nationally (98th percentile; labeled an "extreme outlier, far above typical national volume for this code") and 99212 ranks #2762 of 99011 (97th percentile; "notably above typical national volume"). This pattern — very high E/M claim counts (e.g., 894 claims for 99213) alongside moderate Mohs volume — suggests a high outpatient clinic throughput that generates substantial visit-driven revenue.

The procedure mix also shows heavy use of lesion management and destruction procedures consistent with general dermatology practice: for example, 11102 (single lesion biopsy) generated $25.6K across 365 claims, 17000 (destruction of a premalignant lesion) produced $24.5K across 597 claims, and 17003 (add-on for additional destroyed lesions) shows 1.4K claims for $6.8K. Taken together, these counts indicate frequent use of in-office destructive treatments and biopsies, reinforcing the picture of a high-volume outpatient dermatology clinic focused on lesion diagnosis and treatment.

Payer-mix and growth considerations: with $349.2K billed to Medicare and "none" recorded to Medicaid, the provider has effectively no Medicaid exposure on file, which reduces complexity from a state-program perspective but concentrates public-payer risk on Medicare. For payers or networks assessing contracting or access, this profile signals a mature Medicare-oriented practice with potential capacity in commercial or self-pay channels not captured here, but also a vulnerability if Medicare patient volume or reimbursement changes materially.

Medicare: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	180	$510	$89.4K
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…	890	$60	$53.6K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	140	$340	$47.6K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	370	$70	$25.6K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	600	$40	$24.5K
17313	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	30	$500	$17K
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,…	310	$40	$12K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	120	$80	$10.3K
17314	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	30	$320	$8.3K
12032	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.	40	$190	$8.1K

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Edward Frank — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	12	10	350	$380	$144.3K
17312	10	10	160	$270	$58.3K
17313	11	10	80	$430	$32.4K
13132	11	20	60	$190	$16K
99214	1,771	3,150	110	$80	$13.2K
17000	20	120	190	$40	$11.4K
11102	12	100	120	$60	$9.6K
17110	46	110	110	$70	$9.4K
17314	5	10	30	$270	$7.4K
12032	11	40	20	$180	$7.4K

Showing 1–10 of 26

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beth Israel Deaconess Medical Center, Inc.	MA	General Acute Care Hospital	$0	$270.4M
Robert Najarian	MA	Anatomic Pathology Physician	$520.7K	$878.6K
Sheldon Buzney	MA	Ophthalmology Physician	$1.4M	$0
Irene Piryatinsky	MA	Psychologist	$169.6K	$1M
Alireza Sepehr	MA	Anatomic Pathology & Clinical Pathology Physician	$1.2M	$1000
Megan Nichols	KS	Ophthalmology Physician	$1M	$0
Stephen Lyle	MA	Anatomic Pathology Physician	$852.2K	$40.3K
Joseph Raevis	NJ	Ophthalmology Physician	$874.9K	$500
Anh Ngo	NH	Interventional Pain Medicine Physician	$815.5K	$0
Herman Lu	CA	Cardiovascular Disease Physician	$789.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Council Of Nashua Nh, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$75.7M
Harbor Homes, Inc.	NH	Federally Qualified Health Center (FQHC)	$0	$23.4M
Southern New Hampshire Medical Center	NH	General Acute Care Hospital	$0	$22.3M
Life Coping Inc.	NH	Case Management Agency	$0	$17.6M
King Healthcare Group LLC	NH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$15.1M
Plus Co. Inc.	NH	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.8M
St Joseph Hospital Of Nashua Nh	NH	General Acute Care Hospital	$0	$13M
Alpha Home Care Solutions, Inc	NH	Home Health Agency	$0	$8.4M
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$8.1M
Nashua Center For The Multiply Handicapped, Inc.	NH	In Home Supportive Care Agency	$0	$6.8M

Edward Frank — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References