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

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

Elaine Shields (NPI 1316211758)

Field	Value
Entity Type	Individual
Organization	Elaine Shields
Address	410 Lindsey St
City	Newport
State	KY
ZIP	41071
Taxonomy	Registered Nurse
NPI Enumerated	March 2, 2012

Payer Source	Total Paid
Medicare	$32.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	70	$140	$9.4K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	140	$40	$5.1K
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…	100	$40	$4.2K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	140	$30	$3.9K
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…	50	$90	$3.8K
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…	30	$120	$3.5K
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…	30	$60	$1.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	50	$20	$1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Elaine Shields — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	6,028	7,230	110	$70	$14.1K
99349	140	190	110	$70	$13.8K
11721	104	160	260	$30	$13K
99350	54	80	50	$110	$9.2K
11042	47	170	80	$60	$8.6K
99213	3,080	7,250	80	$50	$7.7K
99345	1	40	20	$120	$3.3K
99212	487	1,520	30	$30	$1.9K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
University Of Cincinnati Physicians Company, LLC	OH	Family Medicine Physician	$0	$65.2M
Joseph Palumbo	WV	Emergency Medicine Physician	$7.9M	$44.3K
The Christ Hospital Medical Associates, LLC	OH	Internal Medicine Physician	$0	$6.8M
Shelita Jones	TX	Family Nurse Practitioner	$6.7M	$0
Raymond Wawrowski	OH	Physician Assistant	$4.7M	$0
Kelly Wayt	OH	Nurse Practitioner	$1.3M	$0
Linda Chen	FL	Internal Medicine Physician	$555.9K	$0
Sadie Lindquist	OH	Family Nurse Practitioner	$543.9K	$0
Tiffany Colston	OH	Adult Health Nurse Practitioner	$517.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ethos Holding Corp	KY	Clinical Medical Laboratory	$17.8M	$28.5M
Healthpoint Family Care Inc	KY	Federally Qualified Health Center (FQHC)	$0	$29.1M
Michael Wehmann	KY	Ophthalmology Physician	$171.2K	$0
Robert Toltzis	KY	Cardiovascular Disease Physician	$138.9K	$0
Darek Sanford	KY	Cardiovascular Disease Physician	$116.2K	$0
Elizabeth Czirr	KY	Optometrist	$51.1K	$8.9K
Richard Abrahamson	KY	Ophthalmology Physician	$52K	$0
Michelle Garrison	KY	Physician Assistant	$33.1K	$0
Kristin Legrand	KY	Nurse Practitioner	$22.4K	$0

Elaine Shields — Billing Profile & Reimbursement Data

Sign up for Elaine Shields — Billing Profile & Reimbursement Data policy alerts

Elaine Shields — Billing Profile & Reimbursement Data

Sign up for Elaine Shields — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References