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

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

Lisa Jones (NPI 1205990520)

Field	Value
Entity Type	Individual
Organization	Lisa Jones
Address	3501 Cranberry Blvd
City	Weston
State	WI
ZIP	54476
Taxonomy	Gastroenterology Physician
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicare	$21.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	30	$190	$6.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	50	$100	$5.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	40	$70	$2.5K
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	10	$160	$2.2K
91122	N/A	30	$60	$1.9K
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…	30	$40	$1.3K
99214	The provider sees an established 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…	20	$70	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Lisa Jones — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	214	320	60	$230	$16.8K
99214	8,765	9,800	80	$70	$9.2K
45380	116	300	40	$130	$7.6K
G0105	131	180	20	$220	$6.4K
43239	200	320	50	$80	$4.8K
99213	6,582	9,380	60	$50	$4.7K
91122	1	10	20	$60	$1.1K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Luke's Hospital Of Duluth	MN	General Acute Care Hospital	$0	$26.6M
Holland Community Hospital	MI	General Acute Care Hospital	$0	$23.7M
The East Alabama Health Care Authority	AL	General Acute Care Hospital	$0	$6.2M
Eamc Er Physicians	AL	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.6M
Edward Parma	AL	Retina Specialist (Ophthalmology) Physician	$1.2M	$0
David Walker	NC	Cardiovascular Disease Physician	$1M	$0
Farhan Tahir	PA	Rheumatology Physician	$1M	$0
Rachel Kruspe	AL	Hematology & Oncology Physician	$1M	$0
Neil Pandya	IL	Internal Medicine Physician	$893.3K	$99.1K
Ashvinkumar Patel	TX	Nephrology Physician	$792.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mchs Hospitals Inc	WI	General Acute Care Hospital	$0	$6.4M
Todd Johnson	WI	General Practice Dentistry	$0	$3.8M
Alexis Powell	WI	Behavior Analyst	$0	$3.2M
Aspirus Medical Group, Inc.	WI	Clinic/Center	$0	$2.5M
D.c. Everest Area Schools	WI	Local Education Agency (LEA)	$0	$2.4M
Compass Counseling Wausau, LLC	WI	Group Psychotherapy Psychologist	$0	$2.2M
Mchs Hospitals Inc	WI	Clinic/Center	$0	$1.2M
Glenn Dym	WI	Clinical Cardiac Electrophysiology Physician	$264.1K	$0
Chong Lee	WI	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$183.3K	$0
Dan Gavrila	WI	Interventional Cardiology Physician	$131.2K	$40

Lisa Jones — Billing Profile & Reimbursement Data

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Lisa Jones — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References