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

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

Ria Gripaldo (NPI 1174788913)

Ria Gripaldo is a pulmonary disease physician provider located in Rochester, Minnesota. This profile covers 15 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Ria Gripaldo
Address	200 1st St Sw
City	Rochester
State	MN
ZIP	55905
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	July 22, 2008

Payer Source	Total Paid
Medicare	$83.6K
Medicaid	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	150	$130	$19.1K
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…	180	$100	$17.3K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	50	$170	$8.3K
99204	The provider sees a new 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 provider…	60	$130	$7.3K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	150	$40	$6.8K
94726	The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may…	150	$40	$6.1K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	140	$30	$4.3K
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…	60	$70	$3.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	$90	$3.6K
94618	The provider performs pulmonary stress testing to evaluate lung function and to diagnose certain lung disorders. The stress component may include a six–minute walk test or other form of exercise.	110	$30	$2.9K

Showing 1–10 of 15

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	1,709	2,570	60	$90	$8.4K
99214	1,658	10,100	70	$80	$8.1K
99215	236	4,060	30	$120	$5.9K
99232	3,531	3,640	60	$60	$5.2K
99205	161	1,350	20	$150	$4.1K
99213	3,761	9,120	50	$50	$4K
94729	27	130	60	$30	$3.7K
99204	419	3,340	20	$110	$3.6K
94726	20	110	50	$30	$2.6K
94375	8	50	60	$30	$2.6K

Ria Gripaldo — Billing Profile & Reimbursement Data

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Ria Gripaldo — 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