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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Sebastian Francis (NPI 1164645933)

Field	Value
Entity Type	Individual
Organization	Sebastian Francis
Address	3110 Maccorkle Ave Se
City	Charleston
State	WV
ZIP	25304
Taxonomy	Emergency Medicine Physician
NPI Enumerated	April 10, 2007

Payer Source	Total Paid
Medicare	$47.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	290	$90	$26.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	180	$50	$9.2K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	50	$140	$6.6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	20	$160	$3.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	40	$30	$900

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Sebastian Francis — 3 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	296	420	90	$130	$15.5K
99291	294	420	40	$160	$9.8K
99284	6	450	80	$90	$8.2K
99283	1	310	30	$50	$1.9K
99282	2	60	20	$30	$500

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sound Physicians Emergency Medicine Of West Virginia PLLC	WV	Emergency Medicine Physician	$0	$1.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthteam Critical Care Transport LLC	WV	Land Ambulance	$2.5M	$19.8M
Cabin Creek Health Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.2M
Holistic, Inc	WV	Family Medicine Physician	$0	$8M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.1M
Imad Shammaa	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.2M
Summit Bhc West Virginia LLC	WV	Substance Use Disorder Rehabilitation Hospital Unit	$0	$5.1M
General Anesthesia Services Inc	WV	Anesthesiology Physician	$0	$4.3M
Neurology & Headache Clinic PLLC	WV	Neurology Physician	$0	$3.8M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$3.3M
Don E. Skaff, Dds, Inc.	WV	Pediatric Dentistry	$0	$2M

Sebastian Francis — Billing Profile & Reimbursement Data

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Sebastian Francis — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References