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

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

Emily James (NPI 1194485144)

Field	Value
Entity Type	Individual
Organization	Emily James
Address	1180 College Dr
City	Rock Springs
State	WY
ZIP	82901
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 17, 2021

Payer Source	Total Paid
Medicare	$2.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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,…	30	$30	$930
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…	20	$50	$720
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	10	$40	$470

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wyoming Distribution

Emily James — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	816	850	110	$60	$9.9K
99212	192	350	30	$40	$2.4K
Q0091	8	10	20	$40	$710

Related Providers

Other providers that share a Tax Identification Number (TIN) with Emily James, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital Of Sweetwater County	WY	Internal Medicine Physician	$0	$1.1M
Kishore Rasamallu	GA	Internal Medicine Physician	$1M	$0
Memorial Hospital Of Sweetwater County	WY	Critical Access Hospital	$0	$660.4K
John Hayes	UT	Radiation Oncology Physician	$329.8K	$0
Jeramie Rosales Rodriguez	MO	Psychiatry Physician	$2.1K	$289.9K
Kamran Khan	NV	Pulmonary Disease Physician	$276.3K	$0
Roger Hansen	UT	Radiation Oncology Physician	$235.1K	$0
Rahul Pawar	WY	Nephrology Physician	$198.3K	$0
Gary Van Heuvelen	ID	Radiation Oncology Physician	$178.4K	$0
Sanjay Ramakumar	AZ	Urology Physician	$151K	$0

Emily James — Billing Profile & Reimbursement Data

Sign up for Emily James — Billing Profile & Reimbursement Data policy alerts

Emily James — Billing Profile & Reimbursement Data

Sign up for Emily James — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References