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.

Arnold Wald (NPI 1063488419)

Field	Value
Entity Type	Individual
Organization	Arnold Wald
Address	451 Junction Rd
City	Madison
State	WI
ZIP	53717
Taxonomy	Gastroenterology Physician
NPI Enumerated	February 27, 2006

Payer Source	Total Paid
Medicare	$4.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 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…	70	$40	$2.7K
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…	30	$60	$2K
91065	A hydrogen or methane breath test is a diagnostic procedure to find problems related to gastric functionality such as lactose deficiency, fructose intolerance, bacterial overgrowth, and oro–cecal…	20	$10	$130

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Arnold Wald — 1 of 3 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

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,547	9,800	80	$70	$9.2K
99213	4,167	9,380	60	$50	$4.7K
91065	1	10	10	$10	$210

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lumicera Health Services, LLC	WI	Specialty Pharmacy	$0	$9.4M
Janice Scholz	WI	Behavior Analyst	$0	$5.7M
Bright Dental Madison LLC	WI	Dental Clinic/Center	$0	$5.6M
Brittany Schumacher	WI	Behavior Analyst	$0	$2.8M
Erin Junemann	WI	Behavior Analyst	$0	$2.4M
Joseph Perron	WI	Clinical Psychologist	$0	$1.9M
Jodie Deruyter	WI	Behavior Analyst	$0	$1.9M
Crystal Held	WI	Behavior Analyst	$0	$1.7M
Michelle Sherman	WI	Social Worker	$0	$1.6M
Kimberly Knippel	WI	Behavior Analyst	$0	$1.4M

Arnold Wald — Billing Profile & Reimbursement Data

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Arnold Wald — 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