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

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

Brian Loder (NPI 1184629180)

Key Findings

Field	Value
Entity Type	Individual
Organization	Brian Loder
Address	43391 Commons Dr
City	Clinton Township
State	MI
ZIP	48038
Taxonomy	Foot & Ankle Surgery Podiatrist
NPI Enumerated	June 16, 2005

Payer Source	Total Paid
Medicare	$2M
Medicaid	$0

This provider’s Medicare business is highly concentrated: total Medicare revenue is $2M and the precomputed top 3 Medicare codes account for 98.1% of this provider’s total Medicare revenue. In particular, Q4262 alone represents $1.9M (96.3% of Medicare revenue), indicating the practice’s income is overwhelmingly driven by this single HCPCS add‑on item rather than by routine evaluation-and-management or diverse procedural mix.

The code mix and descriptions point to a supply- and procedure-driven practice model tied to wound/advanced dressing use and related foot procedures. Q4262 (Dual layer impax membrane) dominates revenue, while procedural codes such as 11042 (debridement) and care codes like 29580 (Unna boot) and 20605 (joint/bursa injection) appear in the top claims, suggesting the provider performs wound care/operative interventions alongside office-based treatments for foot and ankle conditions.

Payer mix is effectively single-payer in our dataset: Medicare shows $2M in lifetime revenue while Medicaid shows none ("none below — this provider has no Medicaid billing on file"). This means Medicaid is not a measurable revenue source for this NPI in the available claims, so analyses of public payer exposure should treat the provider as Medicare-centric.

Despite the revenue concentration, the provider is not a national outlier on the leading code: Q4262 ranks #48 of 141 providers nationally (66th percentile) and is described as "typical, unremarkable volume" in the peer distribution. That ranking indicates mid-to-upper activity among the smaller national cohort billing this specific code, but not a dominant national position for Q4262.

Other frequently billed E/M and procedural codes show routine national standing rather than extreme deviation. For example, 99213 (300 claims) ranks #59713 of 457151 providers nationally (87th percentile) and 11042 (183 claims) ranks #2691 of 10712 providers nationally (75th percentile); both are labeled in the source as "typical, unremarkable volume," signaling that office visits and debridement volumes are within expected ranges for peers rather than exceptionally high.

From a competitive and contract review perspective, the practice’s financial profile implies vendor/supply pricing and utilization of Q4262 will disproportionately affect total Medicare spend for this NPI. Since $1.9M of the $2M Medicare revenue is tied to Q4262, payers and network analysts should prioritize review of procurement, coding guidance, and allowed amounts for that HCPCS when evaluating cost containment or agreement terms.

The provider is long‑tenured in Medicare enrollment, with an NPI enumeration date of 2005-06-16 (~21 years ago), which supports stability in longitudinal billing patterns. That tenure combined with a concentrated revenue stream suggests an established clinical workflow centered on the high-revenue supply/procedure represented by Q4262 rather than recently shifted coding behavior.

No codes in the top listing are flagged as statistical outliers in the source; the plain‑English characterizations attached to the ranks (for example, "typical, unremarkable volume" for Q4262, 99213, 99214, and others) indicate the provider’s activity levels fall within expected peer distributions. Therefore, the notable finding is not anomalous statistical behavior but an uncommon dependence on a single high‑value add‑on code for most Medicare revenue.

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	1,960	$960	$1.9M
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…	300	$60	$18.3K
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…	210	$90	$17.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	180	$70	$11.9K
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…	90	$80	$6.9K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	60	$110	$5.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	90	$60	$5.5K
73630	In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality.	110	$20	$2.6K
29580	The provider applies an Unna boot, a spiral compression dressing, made of cotton and zinc oxide paste or other emollients, that keeps the skin moist and free of irritation while applying pressure to…	60	$50	$2.5K
73610	In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area.	30	$30	$840

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Ford Macomb Hospital Corporation	MI	General Acute Care Hospital	$0	$40.9M
Integrated Living, Inc.	MI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$28.5M
Henry Ford Cornerstone Medical Group	MI	Family Medicine Physician	$0	$14.2M
Morc Home Care Inc.	MI	Case Management Agency	$0	$7.6M
Henry Ford Macomb Hospital Corporation	MI	Advanced Practice Midwife	$0	$7.3M
Professional Emergency Care, PC	MI	Emergency Medicine Physician	$0	$5.6M
Clinton Partners, LLC	MI	Ambulatory Surgical Clinic/Center	$886.1K	$0
Mohammadreza Kahnamouei	MI	Adult Medicine Physician	$545.6K	$0
Wei Su	MI	Dermatopathology Physician	$528.1K	$0
Kent Krach	MI	MOHS-Micrographic Surgery Physician	$494.1K	$0

Brian Loder — 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

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	1	10	1,780	$960	$1.7M
99232	3,382	6,730	90	$60	$12K
99214	3,394	15,470	80	$80	$11.4K
11042	46	360	80	$60	$6.7K
99213	1,276	14,810	60	$60	$6.6K
99222	1,221	4,810	30	$100	$5K
99203	491	4,560	30	$70	$3K
29580	19	60	40	$40	$2.3K
20605	111	180	30	$40	$1.7K
73630	207	1,060	40	$20	$1.2K