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

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

Mark Gregory (NPI 1104843663)

Field	Value
Entity Type	Individual
Organization	Mark Gregory
Address	555 N New Ballas Rd
City	Saint Louis
State	MO
ZIP	63141
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicare	$145.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

17 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…	450	$90	$38.7K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	120	$270	$34K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	180	$130	$23.4K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	140	$80	$10.8K
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…	150	$60	$8.8K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	70	$60	$4K
G0009	Administration of pneumococcal vaccine	130	$30	$4K
G0442	Annual alcohol misuse screening, 5 to 15 minutes	190	$20	$3.4K
G0444	Annual depression screening, 5 to 15 minutes	180	$20	$3.3K
G0008	Administration of influenza virus vaccine	100	$30	$3.1K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Mark Gregory — 2 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	885	8,960	100	$80	$13.9K
G0439	262	1,770	60	$110	$10.2K
90677	9	990	20	$270	$7.4K
99213	2,270	8,730	70	$50	$7K
99215	1,902	2,300	30	$110	$6.8K
90694	619	940	60	$70	$6.6K
90662	457	1,510	40	$70	$4.6K
99497	39	280	40	$60	$4.1K
G0008	613	2,260	50	$30	$2.5K
G0402	107	200	10	$150	$2.3K

Showing 1–10 of 17

Mark Gregory — 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