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.

Danielle Stout (NPI 1306380472)

Field	Value
Entity Type	Individual
Organization	Danielle Stout
Address	22 Bramhall St
City	Portland
State	ME
ZIP	04102
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 8, 2016

Payer Source	Total Paid
Medicare	$522.1K
Medicaid	$0

Key Findings

This provider is effectively a single-payer Medicare billing entity with Total Medicare revenue of $522.1K and no Medicaid billing on file; there is no recorded Medicaid activity to evaluate, so payer mix is heavily Medicare-dependent. The absence of Medicaid claims indicates the practice either does not serve Medicaid patients or bills them under a different provider/entity.

Revenue concentration is highly focused: the precomputed top 3 Medicare codes account for 95.0% of this provider's total Medicare revenue, indicating a narrow set of services drives nearly all Medicare receipts. That concentration suggests operations and scheduling are organized around repeated administration of a few specific injectable therapies.

The top revenue-driving codes are J0129, J1745, and J1602, which are all high-volume infusion/injection drug codes (abatacept, infliximab, golimumab). This mix points to a practice oriented toward infused biologic therapy administration rather than broad primary-care procedures, consistent with a service-line model focused on chronic inflammatory or autoimmune conditions.

Competitive standing by code is mixed: for J1745 the provider ranks #203 of 1352 nationally (85th percentile), indicating above-typical national volume and a relatively strong presence for that infliximab administration code. By contrast, J0129 ranks #755 of 1221 (38th percentile) and J1602 ranks #738 of 1041 (29th percentile), positioning those two biologic codes as modest to below-typical contributors versus national peers.

Procedure-level chemotherapy/infusion CPTs appear but represent small shares of revenue: 96413 contributes $15.8K (3.0% of Medicare revenue) and 96365 and 96415 together contribute small portions (1.4% and 0.5% respectively). These add-on and infusion codes imply the provider also performs infusion-related care sessions, but they are secondary to the three primary drug administration codes in revenue impact.

Tenure is notable: the NPI was enumerated on 2016-12-08 (~10 years ago), suggesting roughly a decade of Medicare participation. That tenure supports the development of recurring infusion workflows and patient panels required to generate sustained high-volume biologic administration.

The provider’s national ranking percentiles and the concentration in three injectable biologic HCPCS codes suggest a specialized infusion service rather than a generalized primary care practice; business risk is concentrated in the continued use and reimbursement of those biologic agents. Any shifts in utilization, reimbursement, or referral patterns for abatacept, infliximab, or golimumab could materially affect revenue given the 95.0% revenue concentration.

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	6,650	$30	$226.1K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6,870	$30	$178.6K
J1602	Injection, golimumab, 1 mg, for intravenous use	8,900	$10	$89K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	200	$80	$15.8K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	180	$40	$7.2K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	150	$20	$2.7K
J3489	Injection, zoledronic acid, 1 mg	90	$10	$510

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Danielle Stout — 2 of 7 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

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	3	10	6,880	$30	$207.2K
J1602	5	10	14,850	$10	$163.5K
J1745	1	10	5,320	$30	$121.4K
96413	12	30	170	$100	$20.6K
96365	6	30	90	$50	$5.6K
96415	1	20	80	$20	$1.7K
J3489	10	10	100	$10	$760

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Mainehealth	ME	Community/Behavioral Health Agency	$0	$115M
Central Maine Medical Center	ME	General Acute Care Hospital	$0	$76.1M
Mainehealth	ME	General Acute Care Hospital	$0	$70.7M
Mainehealth	ME	General Acute Care Hospital	$0	$40M
Mainehealth	ME	General Acute Care Hospital	$0	$31.5M
Mainehealth	ME	General Acute Care Hospital	$0	$22.7M
Mainehealth	ME	Rural Health Clinic/Center	$0	$16.7M
Mainehealth	ME	Multi-Specialty Clinic/Center	$0	$10.9M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shalom House, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$81.9M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M
Merrimack River Medical Services, Inc.	ME	Substance Use Disorder Rehabilitation Clinic/Center	$253.7K	$4.6M

Danielle Stout — Billing Profile & Reimbursement Data

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Danielle Stout — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References