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

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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 Kraus (NPI 1275701575)

Field	Value
Entity Type	Individual
Organization	James Kraus
Address	6 Essex Center Dr Suite 112a
City	Peabody
State	MA
ZIP	01960
Taxonomy	Oral and Maxillofacial Surgery (Dentist)
NPI Enumerated	February 20, 2008

Payer Source	Total Paid
Medicare	$11K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	60	$90	$4.7K
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…	50	$70	$3.7K
40812	The provider excises a lesion or area of damaged or diseased tissue of the mucosa, a membrane lining the anterior most part of the mouth, and the submucosa, the layer beneath the mucosa. This…	10	$220	$2.4K
70355	The provider takes panoramic X–rays of the patient’s upper and lower jaws to diagnose a fracture or injury to the jaw.	10	$20	$200

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

James Kraus — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	8,276	13,700	70	$60	$8.8K
99203	1,319	4,290	30	$80	$4.1K
40812	2	10	10	$200	$2.4K
70355	24	30	20	$10	$340

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Able Home Care L.L.C.	MA	Home Health Agency	$0	$42.7M
Cab Health & Recovery Services, Inc.	MA	Community/Behavioral Health Agency	$0	$30.3M
Shore Educational Collaborative	MA	Developmentally Disabled Services Day Training Agency	$0	$18.6M
Rainbow Adult Day Center Inc	MA	Adult Care Home Facility	$0	$10.6M
Vine Homecare & Staffing, Inc.	MA	Home Health Agency	$0	$9.2M
Ideal Health Care System, Inc	MA	Home Health Agency	$0	$6.6M
Massbay Home Care, Inc.	MA	In Home Supportive Care Agency	$0	$5.6M
Namrata Nandakumar	MA	Ophthalmology Physician	$2.2M	$0
Orthopedics Surgical Center Of The North Shore LLC	MA	Ambulatory Surgical Clinic/Center	$1.6M	$285.4K
Michael Indelicato	MA	Rheumatology Physician	$1.4M	$0

James Kraus — Billing Profile & Reimbursement Data

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James Kraus — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References