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

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

Mary Lou Hernandez (NPI 1083668388)

Field	Value
Entity Type	Individual
Organization	Mary Lou Hernandez
Address	901 E Willetta St
City	Phoenix
State	AZ
ZIP	85006
Taxonomy	Clinical Social Worker
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicare	$5.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	50	$40	$2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	20	$60	$1.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	10	$90	$990
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	$40	$790
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	10	$40	$510

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Arizona Distribution

Mary Lou Hernandez — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	241	250	230	$90	$26.3K
90834	79	90	90	$70	$11K
90791	182	190	30	$110	$6.5K
90832	52	60	40	$50	$4.4K
90846	4	10	50	$50	$2.4K

Mary Lou Hernandez — Billing Profile & Reimbursement Data

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Mary Lou Hernandez — 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