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

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

Carlen Smith (NPI 1295199453)

Field	Value
Entity Type	Individual
Organization	Carlen Smith
Address	6 E Chestnut St
City	Augusta
State	ME
ZIP	04330
Taxonomy	Geriatric Medicine (Family Medicine) Physician
NPI Enumerated	April 13, 2016

Payer Source	Total Paid
Medicare	$29K
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
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	100	$130	$12.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	130	$90	$11.4K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	40	$80	$3.5K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	10	$110	$1.5K

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. Maine Distribution

Carlen Smith — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99350	7	40	40	$110	$8K
99349	31	60	50	$80	$5.7K
99215	58	780	30	$100	$4.8K
99205	195	260	20	$140	$4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rachit Kumar	VA	Hematology & Oncology Physician	$802.4K	$0
Bo Pang	ME	Facial Plastic Surgery Physician	$434.3K	$0
Jose Ventura	ME	Family Medicine Physician	$50.9K	$197.8K
Ellie Mueller	ME	Interventional Cardiology Physician	$201.2K	$0
Brian Hyett	NH	Internal Medicine Physician	$189.8K	$0
Sariah Liu	ME	Hematology & Oncology Physician	$160.7K	$0
Allan Andrews	NC	Gastroenterology Physician	$157K	$0
Fred Stucky	ME	Vascular Surgery Physician	$152.2K	$0
Andrew Smith	ME	Foot & Ankle Surgery Podiatrist	$61.4K	$70.5K
Jonathan Evans	ME	Pulmonary Disease Physician	$112.8K	$0

Carlen Smith — Billing Profile & Reimbursement Data

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Carlen Smith — 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

Frequently Asked Questions

References