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

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

Sushmita Thomas (NPI 1124399126)

Field	Value
Entity Type	Individual
Organization	Sushmita Thomas
Address	1525 Clifton Rd Ne
City	Atlanta
State	GA
ZIP	30322
Taxonomy	Adult Health Nurse Practitioner
NPI Enumerated	January 23, 2012

Payer Source	Total Paid
Medicare	$35.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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,…	550	$40	$19.1K
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…	230	$60	$12.8K
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	750	$1	$3K
93793	The provider reviews and interprets a new INR test result of a patient taking regular doses of warfarin after which he adjusts the dosage if needed, instructs the patient on continued treatment, and…	110	$10	$780

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Georgia Distribution

Sushmita Thomas — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	2,858	13,360	80	$60	$9.2K
99212	13	2,720	30	$40	$2.1K
93793	33	80	90	$10	$1.2K
85610	7	320	90	$1	$740

Sushmita Thomas — Billing Profile & Reimbursement Data

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Sushmita Thomas — 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