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

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

John Morris (NPI 1235185315)

John Morris is a nephrology physician provider located in Memphis, Tennessee. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	John Morris
Address	7640 Wolf River Cir
City	Memphis
State	TN
ZIP	38138
Taxonomy	Nephrology Physician
NPI Enumerated	May 26, 2006

Payer Source	Total Paid
Medicare	$352K
Medicaid	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,100	$60	$64.7K
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…	570	$90	$48.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	420	$90	$38K
99458	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.…	1,070	$30	$30.9K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	810	$40	$29K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	820	$40	$28.8K
99454	The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period.	700	$40	$24.6K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	510	$50	$23K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	90	$210	$18.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	130	$130	$16.9K

Showing 1–10 of 14

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	122	130	170	$260	$49.1K
99214	1,021	11,370	120	$80	$16.6K
99233	191	2,630	90	$90	$13.1K
99490	62	400	130	$40	$11.7K
90961	19	130	40	$210	$11.7K
99232	90	3,990	100	$60	$11.4K
99458	7	90	110	$30	$11.4K
99457	10	150	110	$30	$10.5K
99454	10	140	110	$30	$9K
99223	343	3,130	40	$120	$8K

John Morris — Billing Profile & Reimbursement Data

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John Morris — 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