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

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

Elizabeth Houle (NPI 1235399619)

Elizabeth Houle is a ophthalmology physician provider located in Burlington, Vermont. This profile covers 13 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	Elizabeth Houle
Address	111 Colchester Ave
City	Burlington
State	VT
ZIP	05401
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 10, 2008

Payer Source	Total Paid
Medicare	$46.7K
Medicaid	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	250	$40	$10.8K
67904	The provider repairs a drooping eyelid by tightening the levator muscle that controls eyelid movement to improve cosmetic appearance or remove the obstruction to a patient’s vision. He accesses the…	20	$610	$9.2K
15822	In this procedure, the provider surgically trims excess skin from below the upper eyelid, typically to improve the cosmetic appearance of the face.	20	$380	$8K
99203	The provider sees a new 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 provider…	100	$50	$5K
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…	70	$70	$4.8K
37609	In this procedure, the provider incises in front of the ears to locate the temporal artery, and ligates the artery with a suture or clamp. He may also take a biopsy of the artery as an option. A…	20	$120	$2.6K
67840	In this procedure, the provider excises a diseased or damaged area from the eyelid, excluding a chalazion, an inflamed oil gland. If necessary, he closes the wound with sutures.	20	$120	$2.1K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	100	$20	$1.8K
99204	The provider sees a new 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 provider…	20	$80	$1.3K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	30	$20	$480

Showing 1–10 of 13

Elizabeth Houle — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	547	960	90	$70	$10.6K
67904	1	10	20	$610	$9.2K
15822	1	10	20	$380	$8K
99213	141	910	80	$50	$6.7K
92134	70	90	50	$20	$4.3K
99204	255	330	30	$100	$4.1K
92083	21	90	60	$40	$2.8K
99203	41	310	30	$60	$2.7K
37609	1	10	20	$120	$2.6K
92133	82	90	70	$20	$2.1K