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

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

Heather Roberts (NPI 1134302037)

Field	Value
Entity Type	Individual
Organization	Heather Roberts
Address	100 Central Ave
City	Cheyenne
State	WY
ZIP	82007
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 13, 2007

Payer Source	Total Paid
Medicare	$237.6K
Medicaid	$0

Key Findings

This provider’s Medicare business is small-to-midsize in absolute terms, reporting total Medicare revenue of $237.6K and no Medicaid billing on file; the practice is effectively single-payer Medicare in the available data and has no recorded Medicaid revenue to diversify payer mix. The absence of Medicaid billing means Medicaid does not currently contribute to this provider’s revenue base.

Revenue is concentrated in a very small set of services: the precomputed top three Medicare codes account for 47.6% of Medicare revenue, driven by 99213 ($52.1K), 99214 ($33.1K), and J7308 ($28.2K). This concentration indicates that nearly half of Medicare dollars come from recurring office visits and a single dermatologic drug/procedure line.

The code mix points to a hybrid primary care/dermatologic procedural practice model: high-volume E/M codes (99213, 99214, 99203) appear alongside procedure and skin-treatment codes such as J7308 (aminolevulinic acid), 96574 (photodynamic therapy), 11102 (skin biopsy), and multiple shave/excision codes (11301, 11311). Together, these codes suggest an office-based operation focused on evaluation and management of established patients plus routine lesion diagnosis and destruction.

The provider is a national outlier on established-patient office visits: 99213 generates $52.1K and ranks #6423 of 457151 providers nationally (99th percentile) and is described as an "extreme outlier, far above typical national volume" for that code. This unusually high relative volume for 99213 implies a strong reliance on frequent established-patient encounters as a core revenue driver.

Other high-revenue procedure codes show strong but more typical participation versus national peers: 99214 ($33.1K) ranks in the 87th percentile and is recorded as a "typical, unremarkable volume," while J7308 ($28.2K) ranks #163 of 1726 (91th percentile) and is also described as "typical, unremarkable volume." In short, aside from the extreme 99213 presence, the provider’s procedural volumes are notable but not uniquely dominant at the national level.

A cluster of dermatologic procedure codes further characterizes the clinical focus and revenue drivers: 96574 ($16.4K), 17000 ($17.8K) and 11102 ($13.4K) together represent meaningful Medicare revenue and align with an emphasis on photodynamic therapy, premalignant lesion destruction, and biopsies. These procedure revenues reinforce that skin lesion treatment and minor surgical care are important service lines for this practice.

Dependence on a narrow set of Medicare services combined with no Medicaid billing raises operational and payer-concentration considerations: with $237.6K of Medicare revenue and 47.6% coming from the top three codes, changes in Medicare utilization, coding patterns, or coverage for specific dermatologic treatments could materially affect revenues. Analysts should note the single-payer exposure and the practice’s concentrated service mix when projecting financial resilience or negotiating payer contracts.

The provider has an established billing history, with NPI enumerated on 2007-12-13 (~19 years ago), indicating long-tenured participation in Medicare. That tenure, coupled with a sustained high-volume 99213 practice, suggests a stable patient panel and an operational emphasis on frequent established-patient visits over many years.

Medicare: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,000	$50	$52.1K
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…	440	$80	$33.1K
J7308	Aminolevulinic acid HCl for topical administration, 20%, single unit dosage form (354 mg)	90	$310	$28.2K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	570	$30	$17.8K
96574	This code is used to report removal of hyperkeratotic (hardened, dry, scaly) skin lesions that appear precancerous followed by photodynamic therapy that exposes a lesion treated with a…	90	$180	$16.4K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	250	$50	$13.4K
11301	The provider shaves off a single epidermal or dermal lesion of 0.6 to 1.0 cm in diameter from the skin of the trunk, arms, or legs.	200	$70	$13.1K
11311	The provider shaves off a single epidermal or dermal lesion of 0.6 to 1.0 cm in diameter from the face, ears, eyelids, nose, lips, or mucous membranes.	120	$80	$9.1K
99203	The provider sees a new 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 provider…	130	$60	$7.9K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	130	$60	$7.7K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

Heather Roberts — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	19	20	600	$40	$43.1K
J7308	4	10	70	$300	$26.5K
99214	89	780	100	$80	$14.8K
96574	4	10	40	$190	$13K
99213	11	850	110	$60	$9.9K
11102	12	40	130	$60	$9.6K
17110	13	30	100	$70	$8.7K
17000	6	50	120	$30	$8.6K
11301	4	10	160	$70	$8.5K
11311	2	10	100	$90	$7.3K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Heather Roberts, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Holmes	WY	Retina Specialist (Ophthalmology) Physician	$4.1M	$0
Brittney Statler	CO	Ophthalmology Physician	$3.7M	$0
Arthur Korotkin	CO	Ophthalmology Physician	$3.7M	$0
John Purviance	WY	Radiation Oncology Physician	$2.5M	$0
Cary Chisholm	TX	Anatomic Pathology & Clinical Pathology Physician	$2.5M	$24.7K
Matthew Asano	CO	Ophthalmology Physician	$2M	$0
Peter Hovland	CO	Ophthalmology Physician	$1.8M	$0
James Levine	CO	Rheumatology Physician	$1.7M	$0
Navid Moradshahi	CA	Diagnostic Radiology Physician	$1.2M	$0
Angelo Santiago	WY	Specialist	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cheyenne Health & Wellness Center	WY	Community Health Clinic/Center	$0	$2.8M
Lincare Inc.	WY	Durable Medical Equipment & Medical Supplies	$0	$1.5M
Respitech Home Health Care Inc	WY	Durable Medical Equipment & Medical Supplies	$0	$1.4M
Meals On Wheels Of Cheyenne Inc.	WY	Case Management Agency	$0	$1.1M
Cheyenne-laramie County Health Department	WY	Public Health or Welfare Agency	$93.1K	$534.5K
Douglas Wilson	WY	Physical Therapist	$376.9K	$0
Stride Learning Center	WY	Clinic/Center	$0	$364.4K
Pain Consultants Of The Rockies, PC	WY	Pain Medicine (Anesthesiology) Physician	$0	$272.5K
Hope And Healing Counseling, LLC	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$217.9K
Michelle Dowling	WY	Family Nurse Practitioner	$200.7K	$0

Heather Roberts — Billing Profile & Reimbursement Data

Sign up for Heather Roberts — Billing Profile & Reimbursement Data policy alerts

Heather Roberts — Billing Profile & Reimbursement Data

Sign up for Heather Roberts — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References