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

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

Michelle Sherman (NPI 1255539052)

Field	Value
Entity Type	Individual
Organization	Michelle Sherman
Address	1210 Fourier Drive
City	Madison
State	WI
ZIP	53717
Taxonomy	Social Worker
NPI Enumerated	July 3, 2007

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	5,620	$110	$623.3K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	3,090	$130	$410.4K
0365T	Adaptive behavior tx addl	3,840	$80	$311.2K
0369T	Duodenal mucosal resurfacing, endoscopic	1,340	$120	$163.4K
0364T	Behavior treatment	3,940	$10	$55.1K
0368T	Behavior treatment modified additional	1,360	$40	$47.6K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	260	$70	$16.6K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	240	$50	$11.9K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	70	$90	$6.1K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Michelle Sherman — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	54	110	5,170	$80	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	33	110	2,070	$120	$581.8K
0365T	Adaptive behavior tx addl	22	50	3,570	$70	$305.2K
0369T	Duodenal mucosal resurfacing, endoscopic	19	50	1,180	$100	$155.8K
0364T	Behavior treatment	23	50	3,670	$10	$68.2K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	33	80	200	$70	$60.4K
0368T	Behavior treatment modified additional	20	50	1,190	$30	$50K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	18	50	160	$90	$34.6K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	24	30	350	$80	$31K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lumicera Health Services, LLC	WI	Specialty Pharmacy	$0	$9.4M
Janice Scholz	WI	Behavior Analyst	$0	$5.7M
Bright Dental Madison LLC	WI	Dental Clinic/Center	$0	$5.6M
Brittany Schumacher	WI	Behavior Analyst	$0	$2.8M
Erin Junemann	WI	Behavior Analyst	$0	$2.4M
Joseph Perron	WI	Clinical Psychologist	$0	$1.9M
Jodie Deruyter	WI	Behavior Analyst	$0	$1.9M
Crystal Held	WI	Behavior Analyst	$0	$1.7M
Kimberly Knippel	WI	Behavior Analyst	$0	$1.4M
Britney Bries	WI	Pediatric Dentistry	$0	$1.4M

Michelle Sherman — Billing Profile & Reimbursement Data

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Michelle Sherman — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References