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

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

Benjamin Holland (NPI 1164841201)

Field	Value
Entity Type	Individual
Organization	Benjamin Holland
Address	3801 S National Ave
City	Springfield
State	MO
ZIP	65807
Taxonomy	Emergency Medicine Physician
NPI Enumerated	April 15, 2014

Payer Source	Total Paid
Medicare	$38.5K
Medicaid	$0

Key Findings

Provider specialty and service mix align with emergency department practice: the top revenue-driving codes are 99285, 99284 and 99291, which correspond to high-acuity ED evaluation and management and critical care services. Activity counts and per-claim payments show 99285 at 193 claims with $125 avg paid/claim ($24.1K revenue, 62.7% of Medicare revenue), 99284 at 87 claims with $79 avg paid/claim ($6.9K, 17.9%), and 99291 at 40 claims with $162 avg paid/claim ($6.5K, 16.8%), indicating most Medicare billing arises from urgent, high-intensity ED encounters. This code mix is consistent with an emergency medicine physician who is directly providing ED and some critical care-level services rather than primary care or procedure-driven work.

Medicare revenue is highly concentrated: the precomputed top-3 codes account for 97.4% of this provider's total Medicare revenue, and total lifetime Medicare revenue is $38.5K. That concentration means changes in volume or coding on these three ED/critical-care codes would materially affect this provider's Medicare receipts, since nearly all reported Medicare income is tied to a narrow set of evaluation-and-management and critical care codes.

This provider is effectively single-payer from a claims perspective: Total Medicaid revenue is none (no Medicaid billing on file), so all reported public-payer billing in the dataset is Medicare. Analysts should treat this profile as Medicare-focused billing activity rather than balanced Medicare/Medicaid practice mix, which limits inferences about Medicaid market behavior or state-level Medicaid competitiveness.

Competitive standing for high-acuity ED visits is modestly above median: 99285 ranks #15596 of 61347 providers nationally (74th percentile) and is described as "typical, unremarkable volume for this code," indicating a stronger-than-average but not dominant national position for that high-level ED visit. Similarly, 99284 ranks #20150 of 64306 (68th percentile) with the same plain-English label of "typical, unremarkable volume for this code," so both major ED E/M codes show solid but not outsized presence versus peers.

Critical care billing via 99291 represents a meaningful share of Medicare revenue (16.8%) but sits near the middle of national distribution: 99291 ranks #38231 of 71290 providers nationally (45th percentile) and is labeled "typical, unremarkable volume for this code." This means the provider bills a notable amount of critical care time relative to their own revenue mix, even though their national rank for that service is not high.

Ancillary diagnostic work is present but minimal: 93010 (ECG interpretation) generated 151 claims for $906 revenue (2.4% of Medicare revenue) and 93042 generated 18 claims for $90 (0.2%). These small-dollar interpretive code contributions suggest ECG interpretation is performed as a supporting activity to the ED encounters rather than as a separate revenue driver.

Provider tenure in the NPI file shows enumeration on 2014-04-15 (~12 years ago), indicating over a decade of record presence in Medicare billing. That length of enumeration supports interpreting current patterns as established behavior rather than transient initial-year activity.

In absolute scale this is a modest Medicare biller for emergency medicine: lifetime Medicare revenue of $38.5K is limited compared with higher-volume ED practitioners, which could reflect constrained Medicare-facing patient volume, facility-based billing arrangements where the facility bills for most services, or a practice that predominantly serves non-Medicare payers; the data on file do not identify which of these explanations applies.

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
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.	190	$130	$24.1K
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.	90	$80	$6.9K
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…	40	$160	$6.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	150	$10	$910
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	20	$10	$90

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. Missouri Distribution

Benjamin Holland — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	3	1,230	110	$130	$17.6K
99291	2	1,480	50	$160	$11.3K
99284	5	1,250	70	$90	$7K
93010	2	850	140	$10	$2.1K
93042	1	40	30	$10	$280

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lester E Cox Medical Centers	MO	General Acute Care Hospital	$0	$112.3M
Skaggs Community Hospital Association	MO	General Acute Care Hospital	$0	$18.8M
Emergency Room Group Ltd	MS	Emergency Medicine Physician	$0	$9.8M
Lester E Cox Medical Centers	MO	General Practice Physician	$0	$9.2M
Cox-monett Hospital, Inc.	MO	Critical Access Hospital	$0	$6.7M
Levent Akduman	MO	Ophthalmology Physician	$3.1M	$1.4M
Robert Dorsey	FL	Surgery Physician	$4.3M	$0
Jennifer Roberts	IL	Emergency Medicine Physician	$52.2K	$692.5K
Farah Dawood-farah	MI	Endocrinology, Diabetes & Metabolism Physician	$533.3K	$0
Frederick Emge	ID	Pediatric Cardiology Physician	$0	$422.8K

Benjamin Holland — Billing Profile & Reimbursement Data

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Benjamin Holland — 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

Frequently Asked Questions

References