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

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

Billy Boring (NPI 1073571303)

Field	Value
Entity Type	Individual
Organization	Billy Boring
Address	1441 Redbud Blvd
City	Mckinney
State	TX
ZIP	75069
Taxonomy	Family Medicine Physician
NPI Enumerated	May 3, 2006

Payer Source	Total Paid
Medicare	$93.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 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…	810	$50	$43.8K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	260	$120	$30.4K
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…	180	$80	$14.1K
G0402	Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	20	$150	$2.3K
17340	The provider uses cryotherapy to treat acne, typically after the acne fails to respond to topical or systemic medications.	60	$30	$1.8K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,030	$1	$1K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	20	$30	$590
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	30	$10	$210

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Billy Boring — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	11,740	32,500	110	$80	$17.6K
G0439	374	7,110	60	$120	$10.6K
99213	587	29,790	70	$60	$8.4K
G0402	389	920	20	$150	$2.6K
69210	533	780	40	$30	$2.3K
17340	1	10	60	$30	$1.8K
93000	3,028	4,790	50	$10	$1.6K
J3301	221	3,020	140	$1	$260

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Phi Health, L.L.C.	TX	Air Ambulance	$6.1M	$25.9M
North Central Texas Community Health Care Center Inc	TX	Federally Qualified Health Center (FQHC)	$0	$14M
Monte Jones	TX	Hematology & Oncology Physician	$957.1K	$0
Farhan Mohammad	TX	Hematology & Oncology Physician	$872.8K	$0
Nithya Palanisamy	TX	Hematology & Oncology Physician	$850K	$0
Sultan Chowdhary	TX	Hematology & Oncology Physician	$339.1K	$0
Ann Snyder	TX	Family Medicine Physician	$283.8K	$0
Nishant Bhatt	TX	Plastic and Reconstructive Surgery Physician	$266.2K	$0
Muhammad Khan	TX	Cardiovascular Disease Physician	$240.3K	$0
Salman Butt	TX	Nephrology Physician	$225.4K	$0

Billy Boring — Billing Profile & Reimbursement Data

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Billy Boring — 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