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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Karen Jones (NPI 1063920536)

Field	Value
Entity Type	Individual
Organization	Karen Jones
Address	401 E Cheves St Ste 201
City	Florence
State	SC
ZIP	29506
Taxonomy	Family Nurse Practitioner
NPI Enumerated	January 17, 2018

Payer Source	Total Paid
Medicare	$49.9K
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
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	240	$110	$26.5K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	90	$120	$10.4K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	220	$30	$5.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	50	$80	$3.7K
11720	The provider surgically debrides (debulks or removes) 1 to 5 abnormal, diseased, or infected nails.	130	$20	$2.6K
11730	The provider removes part or all of a single nail plate using simple avulsion techniques.	10	$70	$870

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. South Carolina Distribution

Karen Jones — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99349	435	530	240	$80	$30.4K
11721	104	170	390	$30	$15.4K
99350	15	210	40	$120	$9.9K
99345	6	80	30	$130	$4.8K
11720	37	90	110	$20	$4.5K
11730	61	70	30	$80	$2.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mcleod Loris Seacoast Hospital	SC	General Acute Care Hospital	$0	$24.8M
William Jackson	SC	Cardiovascular Disease Physician	$635.8K	$0
Linda Chen	FL	Internal Medicine Physician	$555.9K	$0
Gavin Leask	SC	Cardiovascular Disease Physician	$532.2K	$0
Neerav Sheth	PA	Interventional Cardiology Physician	$525.9K	$0
Amit Pande	SC	Cardiovascular Disease Physician	$504.5K	$0
Nathan Almeida	SC	Cardiovascular Disease Physician	$488.2K	$0
Vinod Jona	SC	Pulmonary Disease Physician	$482.5K	$0
Alexander Bustamante	VA	Cardiovascular Disease Physician	$476K	$0
Anne Everman	SC	Cardiovascular Disease Physician	$446.7K	$0

Karen Jones — Billing Profile & Reimbursement Data

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Karen Jones — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References