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

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

Augie Wallace (NPI 1083083455)

Field	Value
Entity Type	Individual
Organization	Augie Wallace
Address	8600 W Chester Pike Ste 308
City	Upper Darby
State	PA
ZIP	19082
Taxonomy	Home Health Aide
NPI Enumerated	September 16, 2015

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W1793	N/A	35,880	$190	$6.9M

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

Augie Wallace — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W1793	N/A	80	370	10,930	$170	$5.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omni Health Services Inc	PA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.8M
Delaware County Department Of Human Services	PA	Case Management Agency	$0	$25.7M
Holcomb Associates, Inc.	PA	Clinic/Center	$0	$20.1M
Everest Urgent Care	PA	Urgent Care Clinic/Center	$0	$17.7M
Care First Nursing	PA	Home Health Agency	$0	$16.5M
Michael Thevar	PA	Mental Health Counselor	$0	$13.3M
Successful Aging Care Net Inc	PA	Home Health Agency	$0	$11.1M
Greater Homecare Services Inc.	PA	In Home Supportive Care Agency	$0	$8.1M
Harwood House	PA	Substance Abuse Rehabilitation Facility	$0	$6.3M
Richard Kareha	PA	Optometrist	$13.7K	$0

Augie Wallace — Billing Profile & Reimbursement Data

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Augie Wallace — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References