Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJohn Clifton
    Ask Trek AI about this page

    John Clifton — Billing Profile & Reimbursement Data

    NPI 1336117381 · San Antonio, TX · Pain Medicine (Anesthesiology) Physician

    Customize your policy alerts

    Sign up for John Clifton — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    John Clifton is a pain medicine (anesthesiology) physician provider located in San Antonio, Texas. This profile covers 21 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJohn Clifton
    Address45 Ne Loop 410
    CitySan Antonio
    StateTX
    ZIP78216
    TaxonomyPain Medicine (Anesthesiology) Physician
    NPI EnumeratedMarch 8, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$317.5K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    21 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    96130The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…540$90$50K
    99213The 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…730$50$36.5K
    99204The 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…300$120$34.7K
    99214The 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…330$90$30.6K
    90833In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…590$50$30.5K
    90838In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient in addition to an evaluation and management service in the…280$90$23.7K
    99205The 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…130$170$21.7K
    99484Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…410$30$13.2K
    90837In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…110$110$12.1K
    99215The 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…90$130$11.5K

    Showing 1–10 of 21

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    21 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    90837455640180$90$22.7K
    908531220420$20$22.4K
    90834379440190$70$20.7K
    90832199350140$50$18K
    992146,61732,500110$80$17.6K
    99492102030$110$13.7K
    992152,1678,73040$120$9.2K
    9921374029,79070$60$8.4K
    96130312030$90$8.2K
    9079148964030$110$8.1K

    Showing 1–10 of 21

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Annette GantzTXFamily Nurse Practitioner$607.7K$0
    Thomas WhiteTXInterventional Pain Medicine Physician$561.5K$0
    Kenneth WuTXInterventional Pain Medicine Physician$435K$0
    Louis SeadeTXOrthopaedic Surgery Physician$374.4K$0
    Yoann MilletTXInterventional Pain Medicine Physician$360.7K$0
    Michael MoghimiTXOrthopaedic Surgery Physician$355.7K$0
    Eric HeinrichTXOrthopaedic Surgery Physician$349K$0
    Mark MoranTXPain Medicine Physician$287.5K$0
    David DodginTXOrthopaedic Surgery Physician$276.3K$0
    Paul GeibelTXOrthopaedic Surgery of the Spine Physician$272.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Pyra Med Health Services, LLCTXHome Health Agency$0$67.7M
    Wave HealthcareTXDurable Medical Equipment & Medical Supplies$0$65.3M
    The Home Care Team, Inc.TXHome Health Agency$0$53.9M
    Outreach Health Community Care Services LPTXPersonal Care Attendant$0$52.8M
    Ability Homecare, LLCTXHome Health Agency$0$52.5M
    Pride Phc Services IncTXHome Health Agency$0$51.6M
    National Nursing And Rehab Sa Pediatrics, LLCTXHome Health Agency$0$46.3M
    Alliance Medical Supply, LLCTXDurable Medical Equipment & Medical Supplies$0$34.8M
    Stonebridge Behavioral Health, P.A.TXClinical Psychologist$0$17.6M
    Premieant IncTXAdult Care Home Facility$0$12.9M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Texas Distribution
    John Clifton — 8 of 21 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Texas