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

Why is the Medicaid comparison limited to Ohio 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. Ohio (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 Kouba (NPI 1073561866)

Field	Value
Entity Type	Individual
Organization	David Kouba
Address	1090 N Shoop Ave
City	Wauseon
State	OH
ZIP	43567
Taxonomy	Dermatology Physician
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicare	$1.9M
Medicaid	$0

Key Findings

This provider’s Medicare billing is dominated by Mohs surgery: code 17311 generated $561.9K (29.2% of the provider’s total Medicare revenue) and code 17312 generated $388.7K (20.2%). Those two procedure codes, together with a high-volume pathology code, indicate the practice’s core service line is surgical dermatology focused on skin cancer excision and margin-controlled procedures.

Revenue is highly concentrated: the precomputed top-three Medicare codes account for 62.7% of this provider’s total Medicare revenue, signaling reliance on a small set of high-value surgical and pathology services rather than broad-based outpatient E/M care. This concentration creates exposure to shifts in reimbursement or referral patterns for those specific codes.

Nationally the provider is a major outlier in Mohs and complex repairs—17311 ranks #27 of 2969 (99th percentile; extreme outlier) and 17312 ranks #5 of 2770 (100th percentile; extreme outlier). The provider is likewise an extreme outlier on complex wound repair 13132 (ranks #28 of 3088, 99th percentile; extreme outlier), which together indicate unusually high national volumes for these specialized surgical procedures.

Pathology and specimen-processing revenue supports the procedural volume: 88305 appears with 4.9K claims, $256.2K revenue (13.3% of Medicare revenue) and ranks #646 of 14580 (96th percentile; typical, unremarkable volume). That level of pathology billing is consistent with in-practice processing or close lab relationships to handle the many surgical specimens generated by Mohs workflows.

The provider’s Medicare-Medicaid payer mix is effectively single-payer: total Medicare revenue is $1.9M while Medicaid shows none on file, indicating the practice is overwhelmingly dependent on Medicare patients and reimbursement. Analysts should treat this entity as Medicare-centric when assessing patient mix, revenue risk, and network participation.

Use of advanced wound and graft products is notable: Q4158 shows 948 claims and $119.4K revenue (6.2% of Medicare revenue) and ranks #10 of 36 nationally, placing the provider among a small group using Kerecis; additional codes for grafts and skin substitutes (15260, 15275, 15271) further document material use of advanced biologic and graft products. This pattern suggests ancillary supply and product spend that contributes meaningfully to total revenue and to per-case cost structure.

Evaluation-and-management codes represent a small share of revenue relative to procedures—99213 produced $20.5K (1.1%) and 99214 produced $10K (0.5%)—which reinforces that the practice generates most revenue from surgical procedures rather than office visits. For payers and network planners, this indicates utilization and resource needs that skew toward operating-room scheduling, pathology throughput, and post-operative care rather than routine outpatient clinic capacity.

The provider has long tenure on file (NPI enumerated 2006-05-04, ~20 years ago) combined with $1.9M in lifetime Medicare revenue, consistent with a well-established, procedure-focused dermatology practice. The combination of longevity, concentrated high-volume Mohs work, and supporting pathology and reconstructive procedures indicates a mature surgical dermatology operation with entrenched referral pathways.

Medicare: Complete Services Breakdown

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

37 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…	1,250	$450	$561.9K
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.	1,270	$310	$388.7K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4,930	$50	$256.2K
Q4158	Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure)	950	$130	$119.4K
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.	210	$450	$94.3K
96910	The provider applies tar or petrolatum to the skin and exposes the area to ultraviolet B, or UVB, rays to treat certain skin diseases such as psoriasis.	1,050	$80	$87.4K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	450	$180	$80.5K
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.	190	$300	$55.2K
15260	This code is for a free full–thickness skin graft of the nose, ears, eyelids, and/or lips that is 20 cm2 or less in size.	60	$740	$42.4K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	540	$70	$39.6K

Showing 1–10 of 37

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

David Kouba — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

37 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	1	90	260	$420	$130.7K
Q4158	1	10	950	$130	$119.6K
17312	1	80	120	$290	$53.3K
88305	15	560	470	$40	$39.2K
17313	4	70	50	$410	$28.2K
96910	1	10	160	$80	$25.8K
14041	9	20	20	$660	$23.9K
15260	6	40	20	$690	$21.4K
14060	13	60	20	$550	$14.8K
13132	2	80	40	$190	$14.8K

Showing 1–10 of 37

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Toledo Clinic Incorporated	OH	Surgery Physician	$0	$15.9M
Joseph Schwartz	MD	Ophthalmology Physician	$4.2M	$0
Toledo Clinic Incorporated	OH	Clinical Medical Laboratory	$2.1M	$2M
Toledo Clinic Incorporated	OH	Clinic/Center	$2.4M	$812.9K
Timothy Kasunic	OH	Hematology & Oncology Physician	$2M	$0
Amir Guerami	CA	Ophthalmology Physician	$1.9M	$0
Albert Li	NY	Retina Specialist (Ophthalmology) Physician	$1M	$329K
Niraj Shah	OH	Ophthalmology Physician	$1.3M	$0
Shaili Desai	OH	Hematology & Oncology Physician	$1.2M	$0
Scott Shay	GU	Vascular & Interventional Radiology Physician	$1.2M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fulton County	OH	Land Ambulance	$252.6K	$486.8K
Christine Kuhlman	OH	Family Nurse Practitioner	$401.1K	$0
Kristen Hug	OH	Physician Assistant	$265.1K	$0
Bradley Adams	OH	Podiatrist	$75.2K	$101.1K
Ted Barber	OH	Neurology Physician	$148K	$0
Kenton Kamp	OH	Family Medicine Physician	$118.7K	$0
Jana Bourn	OH	Family Medicine Physician	$94.1K	$0
Kimberly Hagerman	OH	Family Medicine Physician	$89.6K	$0
John Kamau	OH	Emergency Medicine Physician	$81.4K	$0

David Kouba — 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