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

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

Rebecca Spalding (NPI 1144700204)

Field	Value
Entity Type	Individual
Organization	Rebecca Spalding
Address	75 Francis St
City	Boston
State	MA
ZIP	02115
Taxonomy	Physician Assistant
NPI Enumerated	August 17, 2018

Payer Source	Total Paid
Medicare	$6.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
43762	The provider removes a previously placed gastrostomy tube and replaces it without imaging guidance or gastrostomy tract revision. The replacement may be routine or necessary to replace a dislodged or…	20	$150	$2.7K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	30	$60	$1.9K
36573	Under imaging guidance, the provider places a catheter through the basilic or cephalic vein in the arm and directs it into one of the major veins carrying blood to the heart or directly into the…	30	$60	$1.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Rebecca Spalding — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36573	19	40	30	$60	$1.9K
99221	158	630	20	$60	$1.9K
43762	4	10	20	$60	$1.5K

Rebecca Spalding — Billing Profile & Reimbursement Data

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Rebecca Spalding — 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