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

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

Michelle Downie (NPI 1093137689)

Field	Value
Entity Type	Individual
Organization	Michelle Downie
Address	18112 Us Highway 18
City	Apple Valley
State	CA
ZIP	92307
Taxonomy	Family Nurse Practitioner
NPI Enumerated	January 15, 2014

Payer Source	Total Paid
Medicare	$108.4K
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
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…	810	$90	$72.4K
A4562	Pessary, reusable, non rubber, any type	250	$50	$11.8K
57160	In this procedure, the provider fits and inserts a pessary or similar device into the vagina to treat vaginal wall prolapse or other disorders.	200	$50	$10.7K
64566	In this procedure, the provider applies electrical stimulation to the posterior tibial nerve by inserting a needle electrode through the skin.	100	$90	$8.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$130	$2.2K
51701	In this procedure, the provider places a non–indwelling catheter into the bladder via the urethra for the purpose of intermittent catheterization or catheterization to obtain residual urine left…	40	$30	$1.3K
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	$60	$1.3K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	130	$1	$260

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. California Distribution

Michelle Downie — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,386	37,970	120	$90	$23.2K
64566	140	210	130	$100	$16.5K
99215	13,095	15,360	50	$130	$14.4K
99213	29,562	34,660	80	$70	$13.2K
51701	79	150	40	$40	$2.7K
57160	2	110	30	$60	$2.2K
A4562	1	50	20	$50	$1.7K
81003	295	2,440	30	$1	$300

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Mary Medical Center	CA	General Acute Care Hospital	$0	$52.3M
High Desert Limb Salvage Institute Podiatrist Corp	CA	Podiatric Clinic/Center	$0	$39.8M
Mukeshchandra Patel	CA	Specialist	$946.1K	$1.6M
Rizwan Nurani	CA	Radiation Oncology Physician	$2.4M	$0
Thomas Hoffmann	CA	MOHS-Micrographic Surgery Physician	$1M	$0
Vijay Arora	CA	Obstetrics & Gynecology Physician	$130.3K	$664.8K
Diraj Karnani	CA	Rheumatology Physician	$680.6K	$0
Rama Pathi	CA	Sports Medicine (Orthopaedic Surgery) Physician	$151.3K	$514.6K
Shahid Latif	CA	Radiation Oncology Physician	$624.7K	$0
Pedram Ilbeigi	CA	Urology Physician	$545.9K	$0

Michelle Downie — Billing Profile & Reimbursement Data

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Michelle Downie — 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