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

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

Daniel Mccauliffe (NPI 1164512067)

Key Findings

Field	Value
Entity Type	Individual
Organization	Daniel Mccauliffe
Address	3 Mahoney Ave
City	Rutland
State	VT
ZIP	05701
Taxonomy	Dermatology Physician
NPI Enumerated	October 13, 2006

Payer Source	Total Paid
Medicare	$280.2K
Medicaid	$0

This provider’s Medicare practice is modest in scale with total Medicare revenue of $280.2K and no Medicaid billing on file, indicating public-payer activity is effectively single-payer Medicare for the records shown. The absence of Medicaid billing suggests the provider does not appear to participate in Medicaid or has no reported claims to state Medicaid during the lifetime window available.

Revenue concentration is material at the code level: the precomputed top-3 Medicare codes account for 39.0% of this provider’s total Medicare revenue. The single largest line is 99213 (920 claims, $48.8K revenue, 18.3% of Medicare revenue), followed by procedural dermatology drivers 11102 ($32.3K, 12.1%) and 17000 ($23.1K, 8.7%).

The code mix indicates a predominantly office-based dermatology practice that combines high-volume evaluation-and-management visits with procedural skin care. High counts for E/M codes (99213 with 920 claims and 99212 with 586 claims) alongside biopsies (11102, 504 claims) and lesion destruction/excision codes (17000, 17110, 17261, 17262) point to routine diagnosis and outpatient procedural management of skin lesions as the primary service line.

Competitive standing for common E/M codes is unusually strong: 99213 ranks #7868 of 457151 providers nationally (98th percentile; extreme outlier) and 99212 ranks in the 99th percentile (extreme outlier), signaling much higher than typical national volume for basic established-patient visits. By contrast, several procedural codes are high but less extreme—11102 ranks in the 94th percentile (notably above typical) while 17000 sits at the 89th percentile (typical, unremarkable volume)—showing the provider is particularly prominent for office visit volume relative to peers while procedural volume is elevated but more in line with specialty norms.

Several malignant lesion destruction and excision codes show notable national positioning that supports specialized procedural throughput: 17261 ranks #48 of 2728 providers nationally (98th percentile; notably above typical) and 17262 ranks in the 95th percentile (notably above typical). These placements indicate above-typical activity on cancerous lesion destruction on trunk/limbs, consistent with dermatologic procedural workload that contributes meaningful revenue (each of these codes accounts for about 5.0% of Medicare revenue).

Procedure-to-visit balance: procedural codes together with add-on lesion destruction (17003 with 1.3K claims but low per-claim payment) suggest many encounters include multiple lesion treatments per visit. The presence of 11103 (241 claims) as an add-on biopsy code and 17003 (1.3K claims) as an add-on lesion destruction code reinforces that encounters often involve multiple lesions managed in the same visit, compressing revenue across many low- and mid-value units.

Tenure and potential system familiarity: the NPI was enumerated on 2006-10-13 (~20 years ago), indicating long-standing enrollment in Medicare which may support stable referral relationships and patient panel continuity in the Rutland, VT market. Long tenure combined with high E/M ranks suggests an established ambulatory dermatology presence rather than a newly opened practice.

From a payer and network strategy perspective, the combination of concentrated Medicare revenue, no Medicaid billing on file, and extreme outlier E/M volumes suggests this provider is a strong Medicare-focused ambulatory dermatology resource in the area. For payers or contracting analysts, the provider’s profile flags high visit throughput and routine procedural mix as key negotiation levers, while the lack of Medicaid activity means there is little to no public-state payer data to assess across that dimension.

Medicare: Complete Services Breakdown

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

35 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…	920	$50	$48.8K
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.	500	$60	$32.3K
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.	640	$40	$23.1K
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,…	590	$40	$22.3K
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…	280	$80	$21.3K
17261	The provider destroys a malignant lesion on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 0.6 cm to 1.0 cm in…	150	$90	$13.3K
17262	The provider destroys a malignant lesion on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 1.1 cm to 2.0 cm in…	120	$110	$13.2K
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…	170	$80	$13.2K
11103	The provider biopsies an additional skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. Report +11103 for each separate lesion…	240	$40	$8.9K
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…	140	$60	$8.6K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rutland Mental Health Services	VT	Developmental Disabilities Clinic/Center	$0	$122.1M
Community Health Centers Of The Rutland Region Inc	VT	Federally Qualified Health Center (FQHC)	$0	$20.6M
Rutland Mental Health Services, Inc.	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.7M
Rutland Hospital, Inc.	VT	Psychiatric Hospital Unit	$396.2K	$13.3M
Community Health Centers Of The Rutland Region, Inc.	VT	Pediatrics Physician	$0	$13.6M
Regional Ambulance Service, Inc	VT	Land Ambulance	$1.4M	$5.3M
Vna & Hospice Of The Southwest Region, Inc	VT	Home Health Agency	$0	$4.8M
Bradford Psychiatric Associates. LLC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$4.7M
Community Health Centers Of The Rutland Region, Inc.	VT	Dentist	$0	$4.4M
Community Health Centers Of The Rutland Region, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.3M

Daniel Mccauliffe — 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

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	292	960	90	$70	$10.6K
17282	2	10	100	$90	$9.1K
17110	4	40	100	$60	$7.8K
17000	3	40	170	$30	$7.7K
11102	1	40	140	$50	$7.4K
99213	9	910	80	$50	$6.7K
17272	2	10	90	$70	$6.7K
12032	7	20	20	$170	$5.8K
12052	6	10	40	$130	$5.7K
11642	1	10	50	$110	$4.2K