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

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

Karen Swanson (NPI 1316911605)

Karen Swanson is a pulmonary disease physician provider located in Scottsdale, Arizona. This profile covers 18 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Karen Swanson
Address	13400 E Shea Blvd
City	Scottsdale
State	AZ
ZIP	85259
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	February 14, 2006

Payer Source	Total Paid
Medicare	$69.1K
Medicaid	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	60	$170	$9.6K
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…	50	$140	$7.1K
31627	In this add–on procedure, the provider uses previously taken CT or MRI images integrated with specialized software to facilitate bronchoscopy.	70	$70	$5.3K
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	$130	$5K
31629	The provider uses a diagnostic rigid or flexible bronchoscope to obtain one or more biopsies from the trachea, main stem, and/or lobar bronchus using a transbronchial needle aspiration technique.	40	$130	$4.6K
31628	The provider uses a rigid or flexible bronchoscope to obtain one or more transbronchial biopsies from a single lobe of the lung. The provider may use fluoroscopic guidance.	70	$60	$4.5K
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…	30	$170	$4.4K
31652	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	30	$140	$4K
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…	40	$100	$3.6K
31653	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	20	$180	$3.4K

Showing 1–10 of 18

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	2,613	2,670	120	$90	$21K
99214	8,121	10,410	120	$80	$20.6K
99291	467	1,210	40	$160	$12.9K
99215	1,478	3,270	50	$120	$11.9K
99232	2,175	3,160	80	$60	$10.4K
99204	2,838	5,790	40	$110	$6.7K
99205	910	1,730	30	$150	$6.6K
31653	11	20	20	$180	$6.1K
99222	1,074	2,160	30	$100	$4.2K
31629	4	10	20	$120	$3.5K

Karen Swanson — Billing Profile & Reimbursement Data

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Karen Swanson — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References