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

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

Jacquelyn Smith (NPI 1154769131)

Field	Value
Entity Type	Individual
Organization	Jacquelyn Smith
Address	3430 Newburg Rd Ste 250
City	Louisville
State	KY
ZIP	40218
Taxonomy	Rheumatology Physician
NPI Enumerated	June 12, 2013

Payer Source	Total Paid
Medicare	$985.3K
Medicaid	$0

Key Findings

This provider is effectively single-payer in the available data: total Medicare revenue is $985.3K while there is no Medicaid billing on file. The absence of any Medicaid claims means payer-mix risk is concentrated entirely in Medicare for the dataset shown.

Revenue is highly concentrated in biologic and infused specialty drugs: the precomputed top-three Medicare codes account for 75.6% of this provider's Medicare revenue, and those codes are J0717, J0129, and J1602. These three codes together drive the majority of professional revenue rather than standard E/M or imaging services.

J0717 is the single largest Medicare revenue source at $303.2K (30.6% of Medicare revenue) with 75.8K claims and an average paid/claim of $4; the file labels its national standing as rank #228 of 848 (73th percentile; typical, unremarkable volume for this code). The combination of very high claim count and low average paid/claim for J0717 is consistent with billing for a drug administered under physician supervision rather than a high per-unit drug reimbursement.

J0129 ($288.8K, 29.2% of Medicare revenue; 8.8K claims, $33 avg paid/claim) and J1602 ($156.5K, 15.8% of Medicare revenue; 15.7K claims, $10 avg paid/claim) round out the top three, reinforcing that biologic infusion/injection therapies are the practice’s dominant service line. Both codes are described as typical, unremarkable volume nationally (J0129 rank #564 of 1221, 54th percentile; J1602 rank #433 of 1041, 58th percentile), indicating the provider is a stable, not dominant, participant in the national market for these products.

Beyond injectable biologics, the provider bills for in‑office infusion and procedure support codes—96365 appears with 276 claims and $12.4K revenue, and 96372 shows 410 claims with $4.1K revenue (96372 ranks #2279 of 58224, 96th percentile; typical, unremarkable volume for this code). The presence of these administration codes plus imaging 76881 (212 claims, $8.1K; rank #146 of 1606, 91th percentile) suggests the practice operates clinic-based infusion and procedural services in addition to prescribing biologics.

Clinical visit volume includes 353 claims for 99214 generating $28.2K (2.9% of Medicare revenue) and ranks #82175 of 479517 (83th percentile; typical, unremarkable volume for this code), indicating steady moderate-complexity follow-up visits. While visit and imaging revenues are small relative to biologics, these E/M and admin codes point to ongoing outpatient management and monitoring consistent with a rheumatology practice that provides in-office treatment and follow-up.

The provider has been enumerated since 2013-06-12 (~13 years ago), indicating an established practice presence over a multi-year period. Combined with the medication-centric revenue mix and the Medicare-only billing profile, this suggests a long-standing specialty clinic focused on biologic therapy delivery to Medicare beneficiaries.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	75,800	$1	$303.2K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	8,750	$30	$288.8K
J1602	Injection, golimumab, 1 mg, for intravenous use	15,650	$10	$156.5K
J3262	Injection, tocilizumab, 1 mg	29,160	$10	$145.8K
J0897	Injection, denosumab, 1 mg	1,680	$20	$31.9K
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…	350	$80	$28.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	280	$50	$12.4K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	210	$40	$8.1K
99204	The provider sees a new 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 provider…	40	$100	$4.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	410	$10	$4.1K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Jacquelyn Smith — 1 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	19	30	9,700	$30	$415.4K
J0717	7	30	46,400	$1	$288.1K
J3262	7	10	33,960	$1	$183.8K
J1602	6	20	11,560	$10	$141.6K
J0897	46	80	2,280	$20	$59.6K
96413	50	50	100	$90	$16.7K
99214	1,148	7,230	110	$70	$14.1K
99213	4,829	7,250	80	$50	$7.7K
96365	10	70	110	$40	$6.4K
99204	1,186	3,200	30	$100	$4.8K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Medical Associates Of The Medical University Of South Carol	SC	Family Medicine Physician	$0	$56.6M
Musc Community Physicians	SC	Internal Medicine Physician	$0	$16.7M
University Medical Associates	SC	Pediatrics Physician	$0	$9.2M
University Medical Associates Of The Medical University Of South Carol	SC	Obstetrics & Gynecology Physician	$0	$6.1M
Musc Community Physicians	SC	Family Medicine Physician	$0	$5.6M
University Medical Associates Of The Medical University Of South Carol	SC	Diagnostic Radiology Physician	$0	$5.4M
University Medical Associates Of The Medical University Of South Carol	SC	Emergency Medicine Physician	$0	$3.6M
University Medical Associates Of The Medical University Of South Carol	SC	Pediatrics Physician	$0	$3.5M
Edward Mcclay	CA	Medical Oncology Physician	$3.4M	$0
University Medical Associates Of The Medical University Of South Carol	SC	Psychiatry Physician	$0	$3.3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Freedom Senior Share, LLC	KY	Adult Day Care Clinic/Center	$0	$142.4M
Keystone Services, Inc Dba	KY	Adult Companion	$0	$55.5M
Breaking Barriers Of Ky LLC	KY	Community/Behavioral Health Agency	$0	$15.3M
Alternative Services For Individuals	KY	Adult Mental Health Clinic/Center	$0	$12.3M
Osting Individual And Family Services Inc	KY	Community/Behavioral Health Agency	$0	$9.6M
Bluegrass Counseling Associates	KY	Clinical Social Worker	$0	$9.4M
Kentucky Case Management, LLC	KY	Case Management Agency	$0	$9.3M
Meeting Challenges LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.4M
Active Day Ky, Inc.	KY	Developmental Disabilities Clinic/Center	$0	$6.1M
Board Of Education Of Jefferson County Kentucky	KY	Local Education Agency (LEA)	$0	$4.9M

Jacquelyn Smith — 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

Nearby Providers

Frequently Asked Questions

References