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    v1.0.28
    OpenPayerNPI Medicare & MedicaidJuanita Carnes
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    Juanita Carnes — Billing Profile & Reimbursement Data

    NPI 1275575342 · Westfield, MA · Nurse Practitioner

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    Juanita Carnes is a nurse practitioner provider located in Westfield, Massachusetts. This profile covers 10 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJuanita Carnes
    Address115 W Silver St
    CityWestfield
    StateMA
    ZIP01085
    TaxonomyNurse Practitioner
    NPI EnumeratedJune 12, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$33.7K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    10 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…320$50$17.5K
    99203The 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…80$70$5.5K
    99214The provider sees an established 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…70$80$5.5K
    87428The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…70$30$2K
    99204The 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…20$100$1.8K
    87880The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.40$20$620
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.20$20$270
    69209The provider flushes or washes (irrigation/lavage) out the entrapped wax (cerumen) from a patient’s external ear canal with a stream of water to correct hearing loss or discomfort.20$10$230
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.10$10$140
    81003The 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…60$1$110

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    10 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992149,60715,410110$80$15.6K
    992131,53313,70070$60$8.8K
    992044,3335,87030$120$5.6K
    992037934,29030$80$4.1K
    8780432835040$20$860
    87428924020$30$820
    878805946020$20$410
    9047110012020$10$260
    810032711,15030$1$220
    692094618020$10$210

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Juanita Carnes, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Mass General Brigham Medical Group Western Massachusetts IncMAFamily Medicine Physician$0$8M
    Sidney Kahn IvMAVascular & Interventional Radiology Physician$945K$0
    James ArcoleoMACardiovascular Disease Physician$617.8K$44K
    Atif KhanMAPrimary Care Nurse Practitioner$76.8K$472.1K
    Joyce WilliamsOHRheumatology Physician$500.7K$0
    Lucian NevilleMACardiovascular Disease Physician$484.7K$0
    Michael ChillMADiagnostic Radiology Physician$372.2K$410
    Vikram GrewalMACardiovascular Disease Physician$348.9K$290
    Steven WeinsierMACardiovascular Disease Physician$338.5K$400
    Daniel SageMAOrthopaedic Surgery Physician$336K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Community Health Care, Inc.MASubstance Use Disorder Rehabilitation Clinic/Center$5.1M$127.2M
    Baystate Noble Hospital CorporationMAGeneral Acute Care Hospital$0$21.9M
    Department Of Mental HealthMACase Management Agency$0$6.4M
    City Of WestfieldMALand Ambulance$883.7K$3.1M
    Lance ReynoldsMAInternal Medicine Physician$318.4K$116.7K
    Sarah BashiruddinMAInternal Medicine Physician$303.8K$20.5K
    John ThayerMAOphthalmology Physician$298K$6.6K
    Akinyele LovelaceMAInternal Medicine Physician$239.6K$32.4K
    Brian Paul SuttonMAEmergency Medicine Physician$47.9K$214.2K
    Ram MalladiMAOtolaryngology Physician$217.3K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Massachusetts Distribution
    Juanita Carnes — 1 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts