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

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

Rachael Nicholson (NPI 1376746354)

Rachael Nicholson is a vascular surgery physician provider located in Iowa City, Iowa. This profile covers 15 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	Rachael Nicholson
Address	200 Hawkins Dr
City	Iowa City
State	IA
ZIP	52242
Taxonomy	Vascular Surgery Physician
NPI Enumerated	June 7, 2007

Payer Source	Total Paid
Medicare	$21.2K
Medicaid	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	130	$30	$3.8K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	110	$20	$2.7K
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…	50	$50	$2.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	80	$20	$1.9K
93971	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arm or leg). This is a unilateral or limited…	120	$20	$1.9K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	70	$30	$1.7K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	170	$10	$1.3K
93926	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts. Providers perform noninvasive arterial diagnostic procedures to examine the rate of blood flow and to…	80	$20	$1.2K
93978	The provider performs a complete study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts using duplex Doppler ultrasound scanning. He performs the study to assess…	40	$20	$980
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…	20	$50	$950

Showing 1–10 of 15

Rachael Nicholson — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	3,403	4,740	100	$50	$8K
93880	28	160	50	$50	$4.2K
93925	11	40	30	$80	$3.9K
99203	1,154	1,600	30	$60	$3.2K
93978	14	30	30	$60	$3.2K
93926	9	30	50	$40	$2.8K
93970	15	140	30	$50	$2.5K
99212	254	1,240	40	$30	$2.1K
93971	20	180	40	$30	$1.7K
93922	8	70	40	$20	$1.6K