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

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

James Clune (NPI 1255566568)

Field	Value
Entity Type	Individual
Organization	James Clune
Address	12902 Usf Magnolia Dr
City	Tampa
State	FL
ZIP	33612
Taxonomy	Plastic and Reconstructive Surgery Physician
NPI Enumerated	May 16, 2009

Payer Source	Total Paid
Medicare	$33.4K
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
14301	The provider replaces the lesions in any area with the healthy tissues from an adjacent site. This code represents a defect of 30.1 cm2 to 60.0 cm2.	20	$640	$12.1K
14302	At the same session that the provider repairs lesions of 30.1 cm2 to 60.0 cm2, with the healthy tissues from an adjacent site, he extends the repair up to an additional 30.0 cm2. The repair may be in…	60	$180	$11.6K
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…	40	$100	$4.1K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	10	$260	$2.8K
99203	The provider sees a new 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 provider…	40	$70	$2.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	20	$30	$420

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. Florida Distribution

James Clune — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
14301	2	90	20	$770	$27.7K
13132	24	430	60	$240	$21.8K
14302	1	30	60	$170	$14.3K
99204	814	19,040	40	$110	$7K
99203	961	11,720	40	$70	$4.4K
99212	1,087	6,920	40	$40	$2.9K

James Clune — Billing Profile & Reimbursement Data

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James Clune — 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