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

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

Agnes Balla (NPI 1194143875)

Field	Value
Entity Type	Individual
Organization	Agnes Balla
Address	111 Colchester Ave
City	Burlington
State	VT
ZIP	05401
Taxonomy	Anatomic Pathology Physician
NPI Enumerated	March 31, 2014

Payer Source	Total Paid
Medicare	$27K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	90	$60	$5.5K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	190	$30	$5.1K
G0416	Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method	30	$130	$4.4K
88360	The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the…	130	$30	$4K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	90	$30	$2.4K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	110	$20	$2.3K
88309	The physician, typically a pathologist, performs a level VI examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	10	$110	$1.3K
88344	The lab analyst applies a single multiplex antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	40	$30	$980
88321	A qualified provider, typically a pathologist, provides consultation and a report on slides prepared elsewhere. A unit of service is the surgical case regardless of the number of slides received.	20	$60	$960

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Agnes Balla — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	28	50	300	$30	$19.9K
G0416	3	10	20	$130	$4.6K
88307	8	30	60	$60	$3.7K
88341	20	40	110	$20	$2.8K
88360	4	10	50	$30	$2.7K
88342	14	40	50	$30	$2.2K
88309	7	10	20	$110	$2.2K
88321	12	10	20	$60	$1.3K
88344	2	10	40	$30	$1.1K

Agnes Balla — Billing Profile & Reimbursement Data

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Agnes Balla — 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