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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Frank Spellman (NPI 1174519615)

Field	Value
Entity Type	Individual
Organization	Frank Spellman
Address	660 Pennsylvania Ave Se
City	Washington
State	DC
ZIP	20003
Taxonomy	Retina Specialist (Ophthalmology) Physician
NPI Enumerated	September 20, 2005

Payer Source	Total Paid
Medicaid	$102K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	640	$100	$62K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	730	$40	$25.6K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	140	$70	$10.1K
92226	N/A	170	$20	$3.5K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	10	$50	$580
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	30	$10	$260

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.

Claims Volume vs. District of Columbia Distribution

Frank Spellman — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	160	310	750	$70	$321.6K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	24	20	510	$30	$50.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	6	10	250	$120	$35.2K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	10	20	1,100	$20	$25.3K
92226	N/A	1	10	90	$10	$1.3K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	6	10	40	$10	$1.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Universal Home Healthcare Inc.	DC	Home Health Agency	$0	$69.8M
Community Connections Inc	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$69.4M
Iya Homes And Community Solutions, LLC	DC	Community/Behavioral Health Agency	$0	$11.3M
Psi Services 111 Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$5.4M
Husband Therapeutics	DC	Home Health Agency	$0	$2.7M
Juanita Bryant	DC	Retina Specialist (Ophthalmology) Physician	$1.9M	$239.4K
Accent On Health, LLC	DC	Internal Medicine Physician	$0	$1.3M
Grubbs Pharmacy Of Dc Inc	DC	Community/Retail Pharmacy	$106.5K	$935.3K
Alfred Burris	DC	Cardiovascular Disease Physician	$469.2K	$356.3K
Christopher Burris	DC	Ophthalmology Physician	$127.7K	$642.6K

Frank Spellman — Billing Profile & Reimbursement Data

Sign up for Frank Spellman — Billing Profile & Reimbursement Data policy alerts

Frank Spellman — Billing Profile & Reimbursement Data

Sign up for Frank Spellman — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References