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

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

James Macdonald (NPI 1366526469)

Field	Value
Entity Type	Individual
Organization	James Macdonald
Address	3601 Tvc
City	Nashville
State	TN
ZIP	37232
Taxonomy	Family Medicine Physician
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicare	$53.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 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…	290	$80	$21.9K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	160	$120	$19.4K
90694	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…	60	$70	$4.4K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	10	$220	$3K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	10	$240	$2.8K
G0008	Administration of influenza virus vaccine	60	$10	$640
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…	10	$40	$470
G0009	Administration of pneumococcal vaccine	20	$10	$220
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	220	$1	$220

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Tennessee Distribution

James Macdonald — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,858	11,370	120	$80	$16.6K
G0439	525	2,650	70	$110	$11.2K
99213	10,941	11,030	80	$50	$8K
90677	1,169	1,340	20	$280	$7.9K
90694	526	1,300	50	$70	$5.7K
90670	9	10	20	$240	$4.7K
G0008	1,242	3,230	50	$30	$2.1K
G0009	701	1,520	20	$30	$730
J3301	406	1,100	140	$1	$310

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kenneth Niermann	TN	Radiation Oncology Physician	$625.8K	$0
Corbin Johnson	TN	Radiation Oncology Physician	$577.1K	$0
Anthony Cmelak	TN	Radiation Oncology Physician	$391.9K	$0
Mark Russell	TN	Diagnostic Radiology Physician	$82.2K	$61.7K
Simone Montoya	TN	Diagnostic Radiology Physician	$137.8K	$0
Christopher Koch	TN	Diagnostic Radiology Physician	$132.7K	$360
Guiyun Wu	TN	Nuclear Medicine Physician	$130.5K	$0
Heather Walker	TN	Family Nurse Practitioner	$128.5K	$0
Kevin Mcmanus	TN	Diagnostic Radiology Physician	$122.4K	$0
Blake Saltaformaggio	TN	Diagnostic Radiology Physician	$118.9K	$0

James Macdonald — Billing Profile & Reimbursement Data

Sign up for James Macdonald — Billing Profile & Reimbursement Data policy alerts

James Macdonald — Billing Profile & Reimbursement Data

Sign up for James Macdonald — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References