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

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

Karen Sullivan (NPI 1245259134)

Field	Value
Entity Type	Individual
Organization	Karen Sullivan
Address	9 Healthcare Dr Ste 101
City	Biddeford
State	ME
ZIP	04005
Taxonomy	Advanced Practice Midwife
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicare	$2.8K
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
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	30	$40	$1.2K
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…	20	$70	$1.1K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	10	$40	$470

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. Maine Distribution

Karen Sullivan — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	2,067	2,350	50	$50	$4.3K
Q0091	6	10	20	$40	$1K
G0101	12	40	20	$30	$910

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$70.7M
Spurwink Services Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$38.6M
Northeast Residential Services	ME	In Home Supportive Care Agency	$0	$29.7M
Counseling And Trauma Therapy Associates	ME	Clinical Social Worker	$0	$12.4M
Mainehealth	ME	Multi-Specialty Clinic/Center	$0	$10.9M
Easy Care Residential	ME	In Home Supportive Care Agency	$0	$10.3M
Maine Behavioral Healthcare	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.9M
Remmes Orthodontics, P.A.	ME	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.8M
Oceanside Community Services	ME	Community/Behavioral Health Agency	$0	$5.5M
Maine Connect Care LLC	ME	Home Health Agency	$0	$4.3M

Karen Sullivan — Billing Profile & Reimbursement Data

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Karen Sullivan — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References