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

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

Michelle De Souza (NPI 1225221476)

Field	Value
Entity Type	Individual
Organization	Michelle De Souza
Address	3901 Rainbow Blvd
City	Kansas City
State	KS
ZIP	66160
Taxonomy	Plastic and Reconstructive Surgery Physician
NPI Enumerated	August 21, 2007

Payer Source	Total Paid
Medicare	$19.9K
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
19316	The provider performs a mastopexy, also called a breast lift, which may involve removing excess skin of the breast and tightening surrounding tissue.	10	$570	$7.4K
14302	At the same session that the provider repairs lesions of 30.1 cm2 to 60.0 cm2, with the healthy tissues from an adjacent site, he extends the repair up to an additional 30.0 cm2. The repair may be in…	50	$150	$7.3K
14301	The provider replaces the lesions in any area with the healthy tissues from an adjacent site. This code represents a defect of 30.1 cm2 to 60.0 cm2.	10	$440	$5.2K

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. Kansas Distribution

Michelle De Souza — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
14301	13	10	20	$880	$35K
14302	2	10	40	$160	$9K
19316	1	10	10	$570	$7.4K

Michelle De Souza — Billing Profile & Reimbursement Data

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Michelle De Souza — 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