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

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

Ira Denny (NPI 1255987475)

Key Findings

Field	Value
Entity Type	Individual
Organization	Ira Denny
Address	16007 N 171st Ln
City	Surprise
State	AZ
ZIP	85388
Taxonomy	Family Nurse Practitioner
NPI Enumerated	August 13, 2019

Payer Source	Total Paid
Medicare	$135.3M
Medicaid	$0

Medicare revenue is overwhelmingly concentrated in a single HCPCS code: Q4262 accounts for $135.2M of the provider’s $135.3M total Medicare revenue (99.9% of Medicare revenue) and 153.3K claims at $882 avg paid/claim. The precomputed top-3 codes together account for 100.0% of this provider’s Medicare revenue, indicating extreme revenue concentration in a very narrow set of services.

The code mix—dominated by Q4262 (dual layer impax membrane per square centimeter) and supplemented by skin substitute graft codes 15274 and 15273—points to a specialized wound-care or skin-substitute service line rather than routine primary care. The presence of multiple skin substitute CPTs suggests the operation centers on application or supply of graft products and related add-on services.

Competitive standing is unusually high for the top codes: Q4262 ranks #1 of 141 providers nationally (100th percentile; extreme outlier), and both 15274 and 15273 rank #1 in their peer sets (100th percentile, with 15273 also labeled an extreme outlier). These ranks indicate the provider is a dominant national outlier in billing volume for these specific codes, even though 15274 and 15273 contribute only $49.9K and $30.4K respectively to Medicare revenue.

This profile is effectively single‑payer Medicare: lifetime Medicare revenue is $135.3M and there is no Medicaid billing on file. The absence of Medicaid activity means payer diversification is nil and the practice’s commercial/Medicaid exposure is either zero or unreported in claims data.

Evaluation-and-management activity is minimal relative to procedural billing: 99203 and 99213 each generated only $2.9K in Medicare revenue despite reporting dozens of claims. That contrast—high-volume supply/procedure codes versus trivial E/M revenue—supports the interpretation that clinical encounters are not the primary revenue driver.

The provider’s NPI was enumerated on 2019-08-13 (~7 years ago), so the accumulated $135.3M in Medicare revenue has been generated over a relatively short operational tenure. Rapid scale in a tight set of codes over this timeframe is notable for analysts tracking growth patterns and benchmarking against peers.

At the claim level Q4262 shows very large transactional volume (153.3K claims) with a high average payment ($882 avg paid/claim), underlining both substantial utilization and material per-unit reimbursement for that code. Those two factors combined (high unit volume and high unit price) explain why a single HCPCS drives virtually all Medicare revenue for this provider.

From a payer and operational risk perspective, the provider’s dependence on a tiny handful of add‑on and skin‑substitute codes makes revenue highly sensitive to reimbursement policy, coding edits, or clinical coverage changes that affect those specific codes. Analysts should consider monitoring coding validation, prior authorization trends, and any policy updates for Q4262 and related skin substitute codes given their outsized impact on the provider’s financial profile.

Medicare: Complete Services Breakdown

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

9 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)	153,290	$880	$135.2M
15274	The provider uses a skin substitute such as an allograft or xenograft to cover a trunk, arms, and/or legs wound surface area of up to an additional 100 cm2 in a patient 10 years or older, or 1…	920	$50	$49.9K
15273	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs that are greater than or equal to 100 cm2. This code covers the first…	200	$150	$30.4K
15278	The provider uses a skin substitute such as an allograft or xenograft to cover wounds on a patient’s face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits,…	80	$60	$5K
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.	50	$100	$5K
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…	50	$60	$2.9K
99213	The provider sees an established 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…	60	$50	$2.9K
15272	At the same session that the provider uses a skin substitute, such as an allograft or xenograft, to cover the wounds on the patient’s trunk, arms, and/or legs up to an area of 100 scm2, the provider…	120	$20	$1.9K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	20	$1	$30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
T.e.a.m. 4 Kids, LLC	AZ	Pediatric Occupational Therapist	$0	$34.7M
Honorhealth-fastmed Ambulatory Holdings LLC	AZ	Urgent Care Clinic/Center	$0	$14.3M
Costco Wholesale Corporation	AZ	Community/Retail Pharmacy	$125K	$0

Ira Denny — Billing Profile & Reimbursement Data

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Ira Denny — 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

Nearby Providers

Frequently Asked Questions

References

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	1	10	31,870	$890	$43.9M
15274	1	10	310	$60	$22.8K
15273	1	10	130	$150	$22.4K
15271	35	40	90	$100	$10.8K
99213	5,645	9,600	80	$60	$9.6K
15278	1	10	80	$60	$5K
99203	1,474	4,100	40	$70	$4K
15272	3	10	110	$20	$1.8K
81003	613	810	30	$1	$440