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

Why is the Medicaid comparison limited to Puerto Rico 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. Puerto Rico (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 Gratton (NPI 1306279864)

Field	Value
Entity Type	Individual
Organization	James Gratton
Address	917 Ave Tito Castro
City	Ponce
State	PR
ZIP	00716
Taxonomy	Emergency Medicine Physician
NPI Enumerated	August 19, 2013

Payer Source	Total Paid
Medicare	$29.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	160	$140	$21.3K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	80	$90	$7.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	100	$10	$590

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

James Gratton — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	23	70	100	$140	$16.4K
99284	26	130	40	$90	$4.7K
93010	13	160	20	$10	$240

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Medicine Services Of Tx, PLLC	TX	Emergency Medicine Physician	$0	$15M
Oxbow Emergency Physicians PLLC	TX	Emergency Medicine Physician	$0	$14.9M
Edinburg Emergency Medicine Associates PA	TX	Emergency Medicine Physician	$0	$11M
Michael Glassinger	LA	Emergency Medicine Physician	$1.5M	$0
Katan Patel	TX	Emergency Medicine Physician	$1.3M	$0
Gregory Messner	TX	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$1M	$0
Mustafa Hindi	IL	Emergency Medicine Physician	$107.8K	$744.8K
Yun Chau Lee	MN	Emergency Medicine Physician	$112.5K	$316.1K
David Abebefe	TX	Emergency Medicine Physician	$209.1K	$0
Jude Regis	LA	Emergency Medicine Physician	$29.5K	$178.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Pathology Services, Inc.	PR	Clinical Medical Laboratory	$6.2K	$5.7M
Tiber Health, Public Benefit Corporation	PR	Multi-Specialty Clinic/Center	$0	$5.1M
Pediatrix Medical Group, S.p.	PR	Neonatal-Perinatal Medicine Physician	$0	$3.8M
Med Centro, Inc.	PR	Clinical Medical Laboratory	$0	$3.6M
Ida Y Vuelta, Inc.	PR	Non-emergency Medical Transport (VAN)	$0	$3.3M
St Lukes Episcopal Church Home Care Program	PR	Community Based Hospice Care Agency	$0	$2.9M
Saint Lukes Memorial Hospital Inc	PR	General Acute Care Hospital	$0	$2.5M
Med Centro, Inc.	PR	Federally Qualified Health Center (FQHC)	$0	$2.3M
St Lukes Episcopal Church Home Care Program	PR	Home Health Agency	$0	$2.2M
Medical X Ray Center Ponce	PR	Radiology Clinic/Center	$0	$2.1M

James Gratton — Billing Profile & Reimbursement Data

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James Gratton — 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