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

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

Jeffrey Fley (NPI 1194728998)

Field	Value
Entity Type	Individual
Organization	Jeffrey Fley
Address	6240 Hamilton Ave
City	Cincinnati
State	OH
ZIP	45224
Taxonomy	Podiatrist
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicare	$3.4M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the sole payer revenue stream on file: Total Medicare revenue is $3.4M and there is no Medicaid billing on file, making the practice effectively single‑payer from an observed claims perspective. The top 3 Medicare codes account for 96.0% of that Medicare revenue, indicating a highly concentrated revenue base.

Two supply-based, per‑square‑centimeter product codes dominate the book of business: Q4236 generated $2M (58.5% of Medicare revenue) across 2.3K claims with an $871 avg paid/claim, and Q4234 generated $1.2M (36.4% of Medicare revenue) across 2.1K claims with a $580 avg paid/claim. These figures show the practice derives the bulk of Medicare dollars from high‑unit, high‑per‑claim wound‑care products rather than traditional E/M or low‑cost procedures.

The taxonomy (Podiatrist) plus the procedure mix — high volumes of Q4236/Q4234, significant counts of debridement codes like 11042 (339 claims) and nail work such as 11721 (1.3K claims) — point to a service line oriented around wound care and procedural podiatry (debridement, nail procedures, and skin substitute grafting). Additional codes for skin substitutes (15275, 15276) and Unna boot application (29580) reinforce a clinic focus on wound management and limb salvage workflows.

Competitive standing is mixed by code: for Q4234 the provider ranks #4 of 23 nationally (86th percentile), indicating a relatively prominent position among the smaller national cohort using that product, while for Q4236 the provider ranks #29 of 79 (64th percentile), a typical volume for that code. For other procedures the provider shows notable national prominence on specific items — 11721 ranks #747 of 12535 (94th percentile) — suggesting stronger relative activity on certain procedural services despite an otherwise product‑driven revenue profile.

There are multiple statistical outliers in the provider’s Medicare mix that suggest atypical service patterns: 17111 is labeled an extreme outlier (rank #33 of 2458, 99th percentile) and 20605 is labeled an extreme outlier (rank #16 of 5794, 100th percentile). These outlier labels, together with the high claim counts for those codes, indicate unusually high volumes of lesion destruction and joint/bursa injections relative to national peers and warrant attention when profiling clinical operations.

Despite the overall $3.4M Medicare revenue, non‑product services and E/M codes contribute very little to total dollars — for example, 99203 represents $2.6K and 99306 $14.1K — which underscores that revenue is concentrated in a few high‑value product codes rather than distributed across office visits or a broad set of procedures. This concentration suggests reimbursement or utilization shifts for Q4236/Q4234 would materially affect topline Medicare revenue.

The provider has an established enrollment history: NPI enumerated 2005-05-24 (~21 years ago). That tenure supports the interpretation that the current billing mix represents a long‑standing practice pattern rather than a transient or newly formed service line.

Operational and contracting implications: with top 3 codes responsible for 96.0% of Medicare revenue and no Medicaid volume, the practice is exposed to changes in coverage, pricing, or utilization of per‑cm2 wound products and lacks payer diversification. Analysts and contract teams should prioritize monitoring reimbursement trends for Q4236 and Q4234 and consider the potential leverage or vulnerability created by the provider’s concentrated dependence on those products.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4236	Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)	2,280	$870	$2M
Q4234	Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure)	2,130	$580	$1.2M
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	1,310	$30	$39.3K
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.	340	$80	$27.1K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	360	$80	$27.1K
17111	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of 15 lesions or more, other than skin tags or…	300	$80	$24.5K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	110	$130	$14.1K
15275	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, up to…	90	$120	$11.3K
20605	In this procedure, the provider inserts a needle through the skin of a patient and into an intermediate joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may…	400	$20	$8.4K
11057	The provider removes more than 4 benign hyperkeratotic lesions by using surgical instruments like a scalpel or curette.	110	$50	$5.1K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

Jeffrey Fley — 4 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4236	1	10	2,280	$870	$2M
Q4234	1	10	1,080	$620	$669.7K
99309	1,394	1,450	180	$70	$21.8K
11721	28	660	330	$30	$12.9K
99306	81	480	50	$130	$9.4K
17110	38	680	80	$70	$8.5K
11042	38	540	90	$60	$7.5K
11057	9	40	40	$60	$5.8K
15275	4	20	50	$100	$5.3K
10061	10	20	20	$160	$5.3K

Showing 1–10 of 18

Nearby Providers

Other providers in the same ZIP code as Jeffrey Fley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quickdraws LLC	OH	Respiratory/Developmental/Rehabilitative Specialist/Technologist	$15.4K	$0

Jeffrey Fley — 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