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

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

Gerald York (NPI 1134190440)

Key Findings

Field	Value
Entity Type	Individual
Organization	Gerald York
Address	3650 Piper Street Suite A
City	Anchorage
State	AK
ZIP	99508
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	January 27, 2006

Payer Source	Total Paid
Medicare	$719.8K
Medicaid	$0

Provider business profile shows a strong concentration in advanced cross-sectional and nuclear imaging: the top three Medicare revenue drivers are A9596 ($138.4K, 23.0%), 70553 ($92.6K, 15.4%), and 78815 ($54.9K, 9.1%), and these three codes together account for 47.5% of the provider’s total Medicare revenue. The presence of A9596 (Ga-68 gozetotide), PET/CT (78815), and multiple brain MRI codes indicates a service line oriented toward oncologic and neuro imaging rather than only routine radiography.

Revenue scale is modest but focused: lifetime Medicare revenue is $719.8K while there is no Medicaid billing on file, making Medicare the effectively sole public-payer revenue source on record. The precomputed concentration figure (top three codes = 47.5%) highlights that a relatively small set of advanced imaging services drives a large share of the practice’s Medicare receipts.

Payer mix is effectively single-payer on-file: Medicaid = none below and Medicare = $719.8K, so analysts should treat this entity as operating almost entirely in the Medicare market or billing to other payers outside the Medicaid dataset. This pattern has implications for network contracting and population coverage analyses, since Medicaid attribution and utilization will not be visible in the data provided.

Competitive standing by code is mixed: 70553 is an "extreme outlier" nationally (ranks #95 of 11271, 99th percentile), showing unusually high Medicare volume for brain MRI with and without contrast. By contrast, A9596 ranks #64 of 168 (62th percentile; typical, unremarkable volume) and 78815 ranks #3055 of 6566 (53th percentile; typical, unremarkable volume), so the practice combines one exceptionally high-volume MRI code with more typical volumes for PET/CT and Ga-68 agent billing.

Several additional CT and MRI CPTs sit at high national percentiles and are described as "notably above typical" for national volume, suggesting broader high throughput in cross-sectional imaging beyond the single extreme outlier. Examples include 74177 ($45.1K revenue; 93th percentile), 70551 ($31.6K; 97th percentile), 70498 ($18.2K; 97th percentile) and 70496 ($17.2K; 96th percentile), indicating sustained capacity for abdomen/pelvis CT, brain MRI, and CT angiography studies.

The provider mixes high-throughput routine imaging with advanced studies: volume of simple chest radiographs (71045, 1.1K claims, $9.5K revenue) and DXA scans (77080, 363 claims, $8.3K revenue) sits alongside high-revenue advanced scans. This blend implies an outpatient imaging workflow that handles both basic, high-frequency exams and referral-driven advanced imaging.

Tenure and local presence are long-established: the NPI was enumerated on 2006-01-27 (~20 years ago), which supports interpreting these utilization patterns as the output of an established radiology practice rather than a recent entrant. Long tenure can strengthen referral relationships that produce high volumes for specific services such as 70553.

Operational and network considerations: the absence of Medicaid billing on file (none below) could reflect non-enrollment in Medicaid, a focus on Medicare-aged patients, or billing arrangements through another entity; analysts should verify enrollment status and contractual participation to understand market coverage. For payer strategy, the high Medicare dependence and concentration in a few advanced imaging codes suggest negotiating leverage and utilization-management focus points for payers evaluating network inclusion.

Medicare: Complete Services Breakdown

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

94 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9596	Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie	170	$840	$138.4K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	490	$190	$92.6K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	60	$870	$54.9K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	360	$130	$45.1K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	310	$100	$31.6K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	230	$130	$28.8K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	520	$40	$22.2K
70498	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's neck using computed tomographic scanning. Noncontrast images, if performed, are included in…	200	$90	$18.2K
70496	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's head using computed tomographic scanning. Noncontrast images, if performed, are included in…	180	$100	$17.1K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	220	$70	$16.1K

Showing 1–10 of 94

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Jefferson Radiology, PC	CT	Diagnostic Radiology Physician	$0	$14M
F&s Radiology, P.C.	FL	Diagnostic Radiology Physician	$0	$7.5M
Malwinder Singha	CA	Vascular & Interventional Radiology Physician	$6M	$0
Alaska Radiology Associates Inc	AK	Body Imaging Physician	$0	$3.8M
Mark Schechter	CA	Diagnostic Radiology Physician	$1.7M	$270
Benjamin Benson	AZ	Diagnostic Radiology Physician	$1.3M	$0
Imaging Associates, LLC	AK	Diagnostic Radiology Physician	$0	$1.2M
Steven Hake	CO	Diagnostic Radiology Physician	$982.7K	$0
Darren Shirley	AK	Diagnostic Radiology Physician	$951K	$0

Gerald York — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9596	3	10	220	$830	$170.1K
78815	5	20	30	$1,000	$106.7K
A9552	10	10	30	$310	$34.1K
64483	16	20	50	$250	$17.9K
74177	8	60	80	$110	$15.5K
70553	1	30	40	$150	$13.7K
62323	20	20	50	$220	$13.1K
72148	3	50	40	$120	$7.5K
27096	11	10	30	$170	$7.2K
74183	4	20	20	$160	$6.6K