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.

Zachary Smith (NPI 1205502200)

Field	Value
Entity Type	Individual
Organization	Zachary Smith
Address	412 State Route 37
City	Akwesasne
State	NY
ZIP	13655
Taxonomy	Physician Assistant
NPI Enumerated	August 19, 2021

Payer Source	Total Paid
Medicare	$5.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	80	$10	$1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	130	$10	$1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	80	$10	$840
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	70	$10	$680
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	80	$10	$620
82948	The clinician performs a test to measure the amount of glucose in a patient's blood using a reagent strip test method.	70	$10	$330
82043	The lab analyst quantitates a timed or random urine specimen for the measurement of albumin. Random means the specimen collection may occur without respect to the time of day. This is a valuable…	40	$10	$260
84439	The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum.	20	$10	$160
82042	The lab analyst quantitates the albumin in a measured, timed, or random specimen, and reports that quantity. Random means the specimen collection may occur without respect to the time of day. For…	20	$10	$120
82570	The lab analyst measures the amount of creatinine, in a patient specimen, other than blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine…	20	$10	$80

Showing 1–10 of 12

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Zachary Smith — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

12 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80061	869	1,460	120	$10	$7.3K
80053	1,139	1,970	120	$10	$6.9K
85025	1,283	2,140	120	$10	$4.8K
84439	751	890	50	$10	$3.2K
83036	881	2,080	50	$10	$3K
36415	3,620	8,110	100	$10	$2.3K
81001	533	540	50	$1	$1.6K
82043	301	700	40	$10	$1.1K
82570	615	710	40	$10	$1K
82042	4	10	30	$10	$700

Showing 1–10 of 12

Zachary Smith — 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