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

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

Sidney Smith (NPI 1326139080)

Field	Value
Entity Type	Individual
Organization	Sidney Smith
Address	1295 Fowler St # 1b
City	Richland
State	WA
ZIP	99352
Taxonomy	Dermatology Physician
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

SIDNEY SMITH’s Medicare activity dominates this billing profile with total Medicare revenue of $2.1M and no Medicaid billing on file; the practice is effectively single-payer from a claims perspective. The top 3 Medicare codes by revenue account for 57.3% of the provider’s Medicare revenue, concentrating most receipts into a small set of procedures and supplies.

The code mix points to a procedural dermatology practice that uses advanced wound and skin-replacement products alongside oncologic and procedural services: Q4253 (962 claims, $516 avg paid/claim, $496.4K revenue, 23.9%) and Q4262 (486 claims, $852 avg paid/claim, $414.1K revenue, 20.0%) are major revenue drivers and represent amniotic/skin-substitute products, while 77600 (628 claims, $441 avg paid/claim, $276.9K revenue, 13.4%) and Mohs codes such as 17311 (292 claims, $487 avg paid/claim, $142.2K revenue, 6.9%) indicate active use of adjunctive hyperthermia and surgical oncology techniques. Together these items suggest a practice that combines reconstructive/complex wound management with dermatologic procedural care rather than pure primary-care office visits.

Revenue concentration is high: the precomputed figure shows the top three Medicare codes represent 57.3% of Medicare revenue, with Q4253 alone accounting for $496.4K (23.9%) and Q4262 for $414.1K (20.0%). This degree of concentration implies that changes in utilization, reimbursement, or contracting for those specific products or procedures could materially affect the practice’s Medicare revenue.

Competitive standing varies by code. For the high-revenue supply codes, Q4253 ranks #45 of 73 (38th percentile; typical, unremarkable volume) and Q4262 ranks #121 of 141 (14th percentile; typical, unremarkable volume), indicating the provider is not a national leader in claim volume for those items despite them driving significant revenue for this provider. By contrast, procedure and planning codes show stronger relative national positioning: 77600 ranks #6 of 35 (85th percentile; typical, unremarkable volume) and 77290 (244 claims, $376 avg paid/claim, $91.7K revenue, 4.4%) ranks #21 of 3650 (99th percentile; extreme outlier, far above typical national volume), signaling outsized activity in certain radiation-therapy planning/simulation services.

Office visit and E/M utilization are notable: 99213 (903 claims, $64 avg paid/claim, $57.8K revenue, 2.8%) ranks #8169 of 457151 (98th percentile; extreme outlier, far above typical national volume), which points to very high volume of routine established-patient visits relative to peers. Complementary E/M levels such as 99214 (469 claims, $89 avg paid/claim, $41.7K revenue, 2.0%) and 99212 (200 claims, $44 avg paid/claim, $8.8K revenue, 0.4%) have higher-than-typical national standings as well, supporting a hybrid model of frequent clinic visits plus procedural services.

Although Mohs surgery codes are present, they are a smaller share of revenue compared with the top supply and therapy codes: 17311 contributes $142.2K (6.9%), 17312 $29.9K (1.4%), and 17313 $35.1K (1.7%). Pathology support is represented by 88305 (1.1K claims, $28 avg paid/claim, $30.1K revenue, 1.5%), which aligns with procedural dermatology workflows but does not dominate the revenue mix. This distribution suggests Mohs and pathology are routine components of care rather than the sole business line.

Several codes indicate specialized service lines and potential contract/leverage points: high unit-paid items such as Q4262 ($852 avg paid/claim) and Q4253 ($516 avg paid/claim) generate outsized revenue even where national volume rank is modest, while 77280 (538 claims, $225 avg paid/claim, $121.1K revenue, 5.8%) ranks #183 of 3348 (95th percentile; typical, unremarkable volume) and adds to a cluster of radiation-related services that are relatively prominent for this provider. These patterns may reflect a clinic model that combines product-driven revenue with technical radiation planning and supportive hyperthermia services.

The provider has an established tenure: NPI enumerated 2006-09-27 (~20 years ago), indicating long-standing billing patterns and potential stability in referral relationships and service mix. That longevity, combined with the concentrated revenue streams and several national percentile outliers, frames both operational strengths and exposure points if payer coverage or utilization of the top codes changes.

Medicare: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4253	Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)	960	$520	$496.4K
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	490	$850	$414.1K
77600	The provider exposes tissue near the surface of a body site, and no deeper than 4cm, to high temperatures of up to 113 degrees Fahrenheit in a technique known as hyperthermia.	630	$440	$276.9K
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	290	$490	$142.2K
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	540	$230	$121K
0394T	N/A	790	$130	$105.9K
77290	Before starting radiation therapy, a physician needs to know the location and size of the cancerous tumor, the radiation doses required to treat the tumor, and the positioning of the radiation beams…	240	$380	$91.7K
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…	900	$60	$57.8K
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…	470	$90	$41.7K
17313	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	70	$500	$35.1K

Showing 1–10 of 43

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Sidney Smith — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

43 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	2	10	910	$900	$818.7K
Q4253	1	10	920	$620	$572.9K
17311	26	70	240	$440	$131.7K
77600	1	10	290	$430	$130.3K
17312	39	60	110	$320	$47.2K
0394T	1	10	290	$130	$44.2K
88305	98	340	530	$40	$39.4K
14301	21	30	20	$850	$26.3K
17313	11	60	40	$450	$22.3K
14041	30	40	20	$670	$20.2K

Showing 1–10 of 43

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephen Doggett	CA	Radiation Oncology Physician	$520.2K	$0
Jeremy Peck	WA	MOHS-Micrographic Surgery Physician	$385K	$0
Austin Lee	ID	Physician Assistant	$149K	$0
Troy Davis	MT	Dermatology Physician	$147.1K	$0
Joseph Oro	SD	Family Medicine Physician	$105.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kadlec Regional Medical Center	WA	General Acute Care Hospital	$0	$151.5M
Gill, Ritchie, Walker PLLC	WA	Ambulatory Surgical Clinic/Center	$0	$10.7M
City Of Richland	WA	Ambulance	$679.8K	$7.8M
Ortc, LLC	WA	Methadone Clinic	$0	$6.2M
Health First Urgent Care, PLLC	WA	Urgent Care Clinic/Center	$0	$5.2M
American Medical Response Ambulance Service Inc	WA	Ambulance	$1.1M	$3M
Total Renal Care Inc	WA	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.8M
Tri-city Orthodontics, LLC	WA	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.9M
Alexey Ryskin	WA	Pain Medicine (Anesthesiology) Physician	$2.3M	$990
Cheryl Lee	WA	Ophthalmology Physician	$1.5M	$0

Sidney Smith — 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