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

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

Melanie Wallace (NPI 1346207222)

Melanie Wallace is a internal medicine physician provider located in Tupelo, Mississippi. This profile covers 36 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	Melanie Wallace
Address	845 S Madison St
City	Tupelo
State	MS
ZIP	38801
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 26, 2006

Payer Source	Total Paid
Medicare	$173.8K
Medicaid	$0

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	760	$80	$58K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	340	$120	$40.2K
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…	300	$60	$16.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	850	$10	$6.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	610	$10	$6.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	360	$10	$4.7K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	90	$40	$3.9K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	30	$140	$3.8K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	20	$200	$3.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	450	$10	$3.6K

Showing 1–10 of 36

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	407	4,110	170	$70	$21.9K
99490	259	330	200	$40	$15.2K
G0439	69	810	70	$110	$14.4K
99213	771	4,000	100	$50	$10.3K
99496	118	170	30	$170	$10.2K
84443	78	280	90	$20	$4.5K
80061	103	530	110	$10	$3.8K
80053	69	520	90	$10	$3.8K
99495	67	230	20	$130	$3.4K
87428	114	250	40	$50	$2.8K

Melanie Wallace — Billing Profile & Reimbursement Data

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Melanie Wallace — 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