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.

Raleigh Jones Jr (NPI 1356439889)

Field	Value
Entity Type	Individual
Organization	Raleigh Jones Jr
Address	740 S Limestone C300
City	Lexington
State	KY
ZIP	40536
Taxonomy	Otolaryngology Physician
NPI Enumerated	October 10, 2006

Payer Source	Total Paid
Medicare	$24.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	160	$60	$9.9K
99203	The provider sees a new 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 provider…	100	$80	$7.7K
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	$80	$2.9K
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…	10	$110	$1.6K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	40	$30	$1.4K
69220	The provider cleans out the cavity left by a mastoidectomy. Patients sometimes require one or more debridement procedures after mastoidectomy before the cavity settles down, i.e., dries out.	20	$60	$880

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Raleigh Jones Jr — 0 of 6 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

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	5,622	7,230	110	$70	$14.1K
99213	2,009	7,250	80	$50	$7.7K
99204	2,759	3,200	30	$100	$4.8K
99203	215	2,380	30	$70	$2.9K
69210	89	190	40	$30	$2.2K
69220	2	10	20	$50	$1.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton Childrens Medical Group, LLC	KY	Pediatrics Physician	$0	$107.3M
Ryan Hall	AR	Hematology & Oncology Physician	$4.6M	$0
Thomas Higgins	KY	Otolaryngology Physician	$207K	$0
Mladen Djurasovic	KY	Orthopaedic Surgery of the Spine Physician	$166.4K	$0
Charles Crawford	KY	Orthopaedic Surgery of the Spine Physician	$158.9K	$0
Sameet Sohi	KY	Otolaryngology Physician	$119.3K	$0
Sin Min Yeoh	KY	Oral & Maxillofacial Surgery (D.M.D.)	$10K	$108.7K
Samuel Quaynor	GA	Neurology Physician	$93.9K	$14.6K
Rodrigo Moreno Garcia	KY	Orthopaedic Hand Surgery Physician	$105.3K	$0
Christian Weigel	KY	Internal Medicine Physician	$105K	$0

Raleigh Jones Jr — Billing Profile & Reimbursement Data

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Raleigh Jones Jr — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References