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.

Erika Smith (NPI 1255683637)

Field	Value
Entity Type	Individual
Organization	Erika Smith
Address	1215 Lee St
City	Charlottesville
State	VA
ZIP	22908
Taxonomy	Physician Assistant
NPI Enumerated	October 9, 2012

Payer Source	Total Paid
Medicare	$17.2K
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
62305	The provider administers an injection of contrast into the lumbar area of the spine and performs myelography of two or more spinal cord regions. The provider also performs radiological supervision…	110	$80	$8.1K
62328	The provider obtains a sample of cerebrospinal fluid (CSF) under fluoroscopic or CT imaging guidance and sends the specimen to the laboratory for examination. The provider commonly performs this…	50	$60	$2.6K
96450	The provider administers a chemotherapy drug into the patient’s central nervous system, or CNS, including the spinal cord. The procedure includes a spinal puncture, which is when the provider inserts…	50	$50	$2.4K
62304	The provider administers an injection of contrast into the lumbar area of the spine and performs myelography at the lumbosacral region. The provider also performs radiological supervision and…	30	$70	$2.3K
62302	The provider administers an injection of contrast into the lumbar area of the spine and performs myelography at the cervical region. The provider also performs radiological supervision and…	10	$80	$980
77003	The provider uses fluoroscopic guidance to place a needle or catheter in the spine or area adjacent to the spinal column to perform procedures to detect the extent or cause of a disease or to treat…	50	$20	$880

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. Virginia Distribution

Erika Smith — 4 of 6 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

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
62305	1	10	10	$80	$3.3K
96450	1	10	50	$50	$2.3K
62304	1	10	10	$100	$1.8K
62328	1	20	20	$70	$1.2K
62302	1	10	10	$80	$980
77003	1	10	20	$20	$380

Erika Smith — Billing Profile & Reimbursement Data

Sign up for Erika Smith — Billing Profile & Reimbursement Data policy alerts

Erika Smith — Billing Profile & Reimbursement Data

Sign up for Erika Smith — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References