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

Why is the Medicaid comparison limited to Mississippi 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. Mississippi (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 Coleman (NPI 1255660593)

Field	Value
Entity Type	Individual
Organization	James Coleman
Address	311 E Main St
City	New Albany
State	MS
ZIP	38652
Taxonomy	Dentist
NPI Enumerated	December 16, 2009

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1351	Sealant - per tooth	26,800	$20	$428.9K
D0150	Comprehensive oral evaluation – new or established patient	9,290	$30	$232.2K
D1120	Prophylaxis–child	10,730	$20	$182.4K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	8,860	$10	$124K
D0140	Limited oral evaluation – problem focused	3,040	$30	$79K
D0272	N/A	4,950	$10	$64.4K
D0274	N/A	1,280	$20	$30.7K
D1208	Topical application of fluoride - excluding varnish	2,620	$10	$26.2K
D0120	Periodic oral evaluation - established patient	1,210	$10	$16.9K
D0350	N/A	620	$20	$10.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

James Coleman — 2 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1351	Sealant - per tooth	10	320	570	$20	$96.7K
D1120	Prophylaxis–child	44	740	1,040	$20	$79.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	37	580	640	$20	$57.5K
D0120	Periodic oral evaluation - established patient	180	540	530	$20	$53.8K
D0150	Comprehensive oral evaluation – new or established patient	21	700	590	$30	$45.9K
D0272	N/A	45	440	440	$20	$36K
D0140	Limited oral evaluation – problem focused	51	640	350	$30	$30K
D0350	N/A	29	90	250	$20	$27.6K
D0274	N/A	94	430	280	$20	$23.3K
D1208	Topical application of fluoride - excluding varnish	94	540	510	$10	$18.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Memorial Hospital Union County, Inc.	MS	General Acute Care Hospital	$0	$32.8M
Cooks Healthcare, LLC	MS	In Home Supportive Care Agency	$0	$24.8M
Internal Medicine And Pediatric Clinic Of New Albany, PLLC	MS	Internal Medicine Physician	$0	$9.9M
New Albany Ob/gyn Clinic PC	MS	Clinic/Center	$0	$6.5M
Spartan Orthopaedics, LLC	MS	Orthopaedic Surgery Physician	$0	$2.8M
James Googe	MS	Pediatrics Physician	$0	$2.4M
Cooks Adult Day Care LLC	MS	Home Health Agency	$0	$1.5M
Renal Care Group Tupelo, LLC	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.4M
William Frohn	MS	Specialist	$6.3K	$633.3K
Marley Rumbarger	MS	Nurse Practitioner	$416.3K	$0

James Coleman — Billing Profile & Reimbursement Data

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James Coleman — 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