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

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

Shelly Bailey (NPI 1174183693)

Field	Value
Entity Type	Individual
Organization	Shelly Bailey
Address	1720 S Beckham Ave Ste 104
City	Tyler
State	TX
ZIP	75701
Taxonomy	Family Nurse Practitioner
NPI Enumerated	June 17, 2019

Payer Source	Total Paid
Medicare	$15.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

11 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…	170	$50	$8.7K
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…	20	$70	$1.4K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	40	$30	$1.4K
57160	In this procedure, the provider fits and inserts a pessary or similar device into the vagina to treat vaginal wall prolapse or other disorders.	20	$50	$1K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	30	$40	$900
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…	10	$50	$550
A4561	Pessary, reusable, rubber, any type	20	$20	$400
Q0111	Wet mounts, including preparations of vaginal, cervical or skin specimens	20	$20	$390
87210	The lab analyst or microbiologist performs a wet mount preparation of a specimen, usually from material collected on a swab or placed directly on a microscope slide.	30	$10	$170
Q0112	All potassium hydroxide (koh) preparations	10	$10	$80

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Shelly Bailey — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	29,511	32,500	110	$80	$17.6K
99213	7,776	29,790	70	$60	$8.4K
99203	9,849	10,820	30	$70	$3.4K
57160	29	60	20	$50	$1.7K
Q0091	189	470	20	$40	$1.3K
G0101	226	940	20	$40	$1.3K
A4561	2	10	20	$20	$510
Q0111	4	10	30	$20	$370
81003	2,801	3,720	30	$1	$240
87210	8	30	20	$10	$160

Showing 1–10 of 11

Shelly Bailey — Billing Profile & Reimbursement Data

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Shelly Bailey — 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