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.

John Smiley (NPI 1245707140)

Field	Value
Entity Type	Individual
Organization	John Smiley
Address	2410 Atherholt Rd
City	Lynchburg
State	VA
ZIP	24501
Taxonomy	Acute Care Nurse Practitioner
NPI Enumerated	October 29, 2018

Payer Source	Total Paid
Medicare	$37.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	430	$60	$26.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	50	$100	$5.1K
93280	In this service, the provider performs a face to face evaluation and then optimally adjusts the existing parameters of an already implanted dual lead pacemaker system. He changes various operating…	70	$30	$2K
33285	The provider inserts a cardiac rhythm monitor with self–contained electrodes into a pocket in the tissues beneath the patient's skin and programs the device according to manufacturer’s directions.	30	$50	$1.7K
93284	In this service, the provider performs a face to face evaluation and then optimally adjusts the existing parameters of various operating functions of an already implanted multiple lead defibrillator…	20	$50	$1.1K
93283	The provider evaluates and adjusts the parameters, or settings, of various operating functions of a previously implanted dual lead transvenous implantable cardioverter defibrillator system, a device…	20	$40	$730
93291	In this service, the provider performs a face–to–face evaluation and then optimally adjusts the existing parameters of various operating functions of an already implanted subcutaneous cardiac rhythm…	20	$10	$290

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

John Smiley — 0 of 7 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

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33285	13	50	20	$1,740	$43.4K
99214	2,455	12,890	140	$80	$21K
99215	1,551	4,030	40	$120	$9.5K
93280	96	180	80	$40	$4.8K
93284	82	110	40	$60	$2.9K
93283	74	90	30	$50	$2K
93291	8	20	20	$30	$690

John Smiley — 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