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

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

Kari Semmes (NPI 1194384222)

Field	Value
Entity Type	Individual
Organization	Kari Semmes
Address	4320 Wornall Rd Ste 710
City	Kansas City
State	MO
ZIP	64111
Taxonomy	Surgical Physician Assistant
NPI Enumerated	June 12, 2019

Payer Source	Total Paid
Medicare	$11.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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	$110	$3.1K
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…	50	$60	$3K
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	$70	$1.3K
61886	The provider makes an incision and implants or replaces a direct or inductive cranial pulse generator or receiver in a subcutaneous pocket for connection to two or more electrode arrays, often one on…	10	$100	$1.1K
99442	N/A	20	$60	$1.1K
61885	The provider makes an incision and implants or replaces a direct or inductive cranial pulse generator or receiver in a subcutaneous pocket for connection to one electrode array. This service is…	10	$60	$740
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	20	$30	$470
63685	The provider inserts or replaces a spinal neurostimulator pulse generator or receiver. The system is one that requires surgical creation of a pocket for placement and that requires a connection…	10	$30	$460

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Kari Semmes — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
63685	20	30	20	$6,300	$144.9K
61885	5	10	20	$450	$10.3K
99213	4,937	8,730	70	$50	$7K
61886	2	10	10	$510	$6.7K
99204	2,379	4,360	30	$100	$4.8K
99203	1,909	2,950	30	$70	$3.2K
99442	96	180	20	$60	$2.5K
99212	1,600	1,930	30	$30	$2K

Kari Semmes — Billing Profile & Reimbursement Data

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Kari Semmes — 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