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

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

Joshua Dalton (NPI 1245498062)

Field	Value
Entity Type	Individual
Organization	Joshua Dalton
Address	14 East 27st N
City	Big Stone Gap
State	VA
ZIP	24219
Taxonomy	Neuromusculoskeletal Medicine & OMM Physician
NPI Enumerated	May 29, 2008

Payer Source	Total Paid
Medicare	$34.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 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…	370	$60	$22.9K
98925	The provider performs controlled manual pressure in one or two body regions to treat somatic and nonsomatic disorders.	230	$20	$5K
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…	30	$110	$3.3K
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	$90	$2K
98926	The provider performs controlled manual pressure in three to four body regions to treat somatic and nonsomatic disorders.	20	$30	$610
98927	The provider performs controlled manual pressure in five to six body regions to treat somatic and nonsomatic disorders.	10	$40	$550

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Joshua Dalton — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	11,522	12,890	140	$80	$21K
99213	1,420	12,440	90	$60	$10K
98926	15	20	70	$30	$7.1K
99204	3,890	6,850	40	$110	$5.9K
98927	12	10	60	$40	$3.8K
98925	1	10	30	$20	$1.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Health System	VA	General Acute Care Hospital	$0	$33.7M
Wellmont Medical Associates Inc	VA	Family Medicine Physician	$0	$24.6M
Frontier Health	VA	Developmentally Disabled Services Day Training Agency	$0	$11.9M
Karen Stallard	VA	Family Nurse Practitioner	$58.1K	$5.3K
Robert Botts	VA	Optometrist	$38.9K	$5.4K
Ginger Collins	VA	Nurse Practitioner	$32.7K	$0

Joshua Dalton — Billing Profile & Reimbursement Data

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Joshua Dalton — 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