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

Why is the Medicaid comparison limited to New York 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. New York (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.

Blanka Kaplan (NPI 1184795270)

Blanka Kaplan is a pediatric allergy/immunology physician provider located in Great Neck, New York. This profile covers 10 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	Blanka Kaplan
Address	Sch - Dept Of Allergy Immunology
City	Great Neck
State	NY
ZIP	11021
Taxonomy	Pediatric Allergy/Immunology Physician
NPI Enumerated	November 13, 2006

Payer Source	Total Paid
Medicare	$30.2K
Medicaid	$0

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

10 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…	90	$120	$10.8K
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…	30	$140	$4.4K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,040	$1	$4.1K
95076	The provider performs this test to identify which foods, drugs, or other substances trigger an allergic response in an individual.	20	$110	$2.6K
95018	This is a type of skin which helps the provider to find out which substance triggers immediate allergic response in an individual. This particular test is sequential and incremental with drugs and…	130	$20	$2.4K
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…	20	$110	$2.3K
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…	30	$80	$2K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	20	$30	$550
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	50	$10	$410
95012	The provider performs a test involving nitric oxide exhaled by a patient into a nitric oxide monitoring system. The test helps with checking the level of inflammation in the airways of a patient who…	20	$20	$360

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	15,227	30,450	90	$100	$19K
99213	26,023	31,440	80	$70	$12.1K
95004	185	300	1,360	$1	$10.4K
99204	6,912	14,170	30	$130	$6.6K
99203	7,508	11,360	30	$90	$4.7K
36415	5,421	8,110	100	$10	$2.3K
95018	13	40	110	$20	$2.2K
95012	70	90	40	$20	$2.2K
94010	577	800	40	$20	$2.1K
95076	5	20	20	$100	$1.8K

Blanka Kaplan — Billing Profile & Reimbursement Data

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Blanka Kaplan — 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