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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

David Jones (NPI 1285998070)

Field	Value
Entity Type	Individual
Organization	David Jones
Address	310 S Splitrock Blvd
City	Brandon
State	SD
ZIP	57005
Taxonomy	Optometrist
NPI Enumerated	June 27, 2012

Payer Source	Total Paid
Medicare	$18.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The 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…	120	$90	$10K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	150	$20	$3.6K
99204	The 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…	40	$80	$3.1K
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…	30	$50	$1.3K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	10	$40	$440

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

David Jones — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	677	1,660	90	$70	$11.4K
99213	1,428	1,710	80	$50	$6.4K
99204	279	670	30	$100	$5.1K
92083	134	140	40	$40	$2.5K
92250	10	120	40	$20	$1.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jones Family Eyecare LLC	SD	Optometrist	$0	$113.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Helping Hand Assisted Living, Inc.	SD	Assisted Living Facility	$0	$3.2M
Med-star Transit LLC	SD	Non-emergency Medical Transport (VAN)	$0	$1.6M
Med Star Paramedic Inc	SD	Land Ambulance	$308.9K	$545.3K
Brandon Valley School District	SD	Local Education Agency (LEA)	$0	$785.4K
New Day Counseling Services, LLC	SD	Mental Health Counselor	$0	$173.8K
Sanford Medical Center	SD	Community/Retail Pharmacy	$78.5K	$0
Fit For Life Chiropractic, LLC	SD	Chiropractor	$0	$62.1K
Shauna Shoultz	SD	Chiropractor	$2.6K	$43.5K
Richard Briggs	SD	Family Medicine Physician	$39.5K	$0
Phillip Dixon	SD	Chiropractor	$38.9K	$0

David Jones — Billing Profile & Reimbursement Data

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David Jones — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References