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

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

David Lafferty (NPI 1063952463)

David Lafferty is a otolaryngology physician provider located in Newark, Delaware. This profile covers 12 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	David Lafferty
Address	700 Prides Xing Ste 200
City	Newark
State	DE
ZIP	19713
Taxonomy	Otolaryngology Physician
NPI Enumerated	March 3, 2017

Payer Source	Total Paid
Medicare	$17.9K
Medicaid	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	30	$120	$3.9K
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…	40	$100	$3.8K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	20	$150	$2.3K
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
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…	20	$70	$1.4K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	50	$30	$1.3K
92504	In this diagnostic procedure, the provider uses a microscope to examine the ears of a patient. He may also sometimes examine the patient’s nose for direct visualization to help with diagnosis…	60	$20	$1.2K
92550	The provider uses this global service code, which bundles tympanometry and reflex threshold measurement when the provider performs both tests to evaluate the middle ear and inner ear, respectively,…	30	$20	$560
G0268	Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing	20	$40	$560
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,…	10	$40	$520

Showing 1–10 of 12

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,478	1,830	150	$80	$25.5K
31231	19	20	120	$130	$19.3K
99213	1,646	1,810	120	$60	$13.6K
99204	507	950	30	$110	$6.5K
99203	509	670	40	$70	$5.3K
92557	28	40	160	$30	$5.2K
69210	48	60	20	$30	$3.4K
99212	452	480	30	$40	$3.1K
92567	28	30	120	$10	$2.4K
G0268	16	20	50	$40	$2K

David Lafferty — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References