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

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

John Simmons (NPI 1104832724)

Field	Value
Entity Type	Individual
Organization	John Simmons
Address	100 East Cahaba
City	Linden
State	AL
ZIP	36748
Taxonomy	General Practice Physician
NPI Enumerated	August 1, 2006

Payer Source	Total Paid
Medicare	$81.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

24 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…	230	$80	$17.9K
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…	280	$60	$15.7K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	290	$50	$13.8K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	80	$120	$9.8K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	200	$40	$8.7K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	70	$30	$2.4K
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	$110	$2.4K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	60	$30	$2.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	230	$10	$2.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	40	$30	$1.2K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

John Simmons — 0 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,256	7,330	120	$80	$16.8K
99308	122	350	170	$50	$15.4K
99490	147	350	150	$40	$14.1K
G0439	648	1,520	70	$120	$11K
99215	1,178	1,710	40	$110	$8.1K
99213	922	6,470	80	$50	$7.9K
99457	77	120	100	$30	$6K
36415	1,114	1,550	100	$10	$4.8K
83036	552	1,080	70	$10	$3.2K
99442	187	220	30	$50	$2.2K

Showing 1–10 of 24

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amstar Emergency Medical Services	AL	Ambulance	$458.5K	$816.4K
Keturah Craig	AL	Podiatrist	$36.7K	$0

John Simmons — Billing Profile & Reimbursement Data

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John Simmons — 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