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

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

Adam Baker (NPI 1245846187)

Field	Value
Entity Type	Individual
Organization	Adam Baker
Address	2440 W Horizon Ridge Pkwy Ste 130
City	Henderson
State	NV
ZIP	89052
Taxonomy	Physician Assistant
NPI Enumerated	September 16, 2020

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is concentrated: lifetime Medicare revenue is $1.8M while Medicaid revenue is listed as none, so the practice is effectively single‑payer (Medicare) in the available data. The NPI was enumerated 2020-09-16 (~6 years ago), indicating roughly six years of recorded Medicare activity to generate that volume.

Revenue is highly concentrated in three product/add‑on codes: the precomputed top three Medicare codes (Q4262, Q4173, Q4253) account for 89.3% of the provider’s Medicare revenue. The single largest line is Q4262, which alone accounts for 49.0% of Medicare revenue ($881.2K from 961 claims at $917 avg paid/claim), followed by Q4173 (28.1%, $504.8K from 718 claims at $703 avg) and Q4253 (12.2%, $219K from 294 claims at $745 avg).

The code mix indicates a product‑heavy, procedure‑oriented practice rather than an E&M‑driven clinic: the top revenue drivers are amniotic/biologic membrane add‑on codes (Q4262, Q4173, Q4253) and there are complementary wound/skin procedure codes on file (97610 for low‑frequency ultrasound with $96.9K, 11000 debridement with $12.9K, and 15271 skin substitute with $11.8K). In contrast, traditional office E&M codes are a small share of revenue (for example, 99214 is $43.3K, 2.4% of Medicare revenue), suggesting the business model centers on device/implant and advanced wound care billings.

Despite the large share of revenue coming from a few codes, the provider is not a dominant national player for those products: Q4262 ranks #94 of 141 providers nationally (34th percentile, characterized as typical/unremarkable), Q4173 ranks #11 of 19 (44th percentile, typical/unremarkable), and Q4253 ranks #69 of 73 (6th percentile, typical/unremarkable). This mix—high revenue concentration but modest national ranks—indicates strong dependence on a few high‑value items without corresponding national leadership in claim volume for those items.

There are pockets of relatively high percentile activity in ancillary services even though they represent modest revenue: 97610 ranks #80 of 320 (75th percentile) and 11000 ranks #25 of 430 (94th percentile), both described as typical/unremarkable in the source but placing this provider above many peers for procedural throughput in wound care and debridement. Those higher percentiles suggest the practice does a measurable volume of hands‑on wound procedures that support its biologic/device billing.

Operational and contracting implications: given that nearly 90% of Medicare revenue is tied to a small set of add‑on biologic/device codes (Q4262, Q4173, Q4253), procurement pricing, supplier relationships, and coverage/medical‑policy acceptance for those products will materially affect revenue. With no Medicaid billing on file (none), payer diversification is limited and business risk is concentrated on Medicare reimbursement policies for these specific products and associated wound‑care services.

Clinical mix versus scale: the practice shows modest overall scale (lifetime Medicare revenue $1.8M over ~6 years) but a specialized clinical orientation toward amniotic/skin substitute products and wound modalities. E&M codes like 99214 ($43.3K, 2.4%) and 99215 ($11.9K, 0.7%) appear as supporting visit activity rather than the primary revenue engine, reinforcing a device/procedure–led revenue profile.

For analysts evaluating competitive positioning, the takeaway is clear: this provider generates most Medicare dollars from per‑square‑centimeter biologic membrane codes and shows operational activity in wound care/debridement, yet ranks modestly or sparsely among national peers for those same codes. Monitoring changes in utilization of Q4262, Q4173, and Q4253 and any emergence of Medicaid billing would be the most direct indicators of shifts in this provider’s business mix or market reach.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	960	$920	$881.2K
Q4173	Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure)	720	$700	$504.8K
Q4253	Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)	290	$750	$219K
97610	The provider uses a low–frequency ultrasound device to try to improve wound healing.	330	$300	$96.8K
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…	520	$80	$43.3K
11000	The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface.	380	$30	$12.9K
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…	100	$120	$11.9K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	110	$100	$11.8K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	80	$80	$6.5K
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…	60	$100	$5.6K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nevada Distribution

Adam Baker — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	8	10	1,300	$980	$3.6M
Q4253	6	10	1,520	$690	$2.9M
Q4173	3	10	720	$740	$732.5K
97610	3	10	180	$310	$98.4K
99214	416	3,610	110	$80	$19K
15271	11	40	80	$110	$17.8K
99215	204	790	40	$120	$12.2K
11042	76	120	120	$70	$11.6K
99213	2,868	3,500	80	$60	$10K
99204	605	2,010	30	$110	$5.8K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Adam Baker, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Family Health Care Inc	ID	Federally Qualified Health Center (FQHC)	$0	$13.9M
Flor Fimbres	AZ	Nurse Practitioner	$8.5M	$0
Valley Family Heatlh Care, Inc	ID	Federally Qualified Health Center (FQHC)	$0	$3M
Nicole Lee	TX	Gerontology Nurse Practitioner	$2.5M	$0
Myrna-leticia Rivas	AZ	Family Nurse Practitioner	$2M	$0
Erika Martin	TX	Family Nurse Practitioner	$1.8M	$0
Shannon Patteson	TX	Family Nurse Practitioner	$1.7M	$0
Demia Louis	TX	Family Nurse Practitioner	$1.7M	$0
Rongna Sun	TX	Family Nurse Practitioner	$1.3M	$0
Christopher Dwiggins	AZ	Medical Physician Assistant	$1.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Platinum Hospitalists LLP	NV	Hospitalist Physician	$0	$38.8M
Urgent Care Nevada, LLC	NV	Urgent Care Clinic/Center	$0	$34.9M
Dignity Health	NV	General Acute Care Hospital	$0	$18.7M
Behavioral Health Solutions LLC	NV	Community/Behavioral Health Agency	$0	$11.4M
Lamotte Pediatrics, LLP	NV	Pediatrics Physician	$0	$9.4M
Minghsun Liu Md PC	NV	Infectious Disease Physician	$0	$5.1M
Optimized Management LLC	NV	Clinical Social Worker	$0	$5M
Misch/hyun/hodapp Healthcare, LLP	NV	Pediatrics Physician	$0	$4.5M
Ellsworth Cox Pediatric Dentistry LLC	NV	Pediatric Dentistry	$0	$3.7M
Total Infusion Care LLC	NV	Home Infusion Therapy Pharmacy	$0	$3.1M

Adam Baker — Billing Profile & Reimbursement Data

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Adam Baker — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References