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

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

Wallace Smith (NPI 1376800532)

Field	Value
Entity Type	Individual
Organization	Wallace Smith
Address	383 S 300 E
City	St George
State	UT
ZIP	84770
Taxonomy	Dermatology Physician
NPI Enumerated	April 12, 2012

Payer Source	Total Paid
Medicare	$580.2K
Medicaid	$0

Key Findings

This provider is effectively single‑payer: lifetime Medicare revenue is $580.2K and there is no Medicaid billing on file, so all analyzed clinical and financial activity in the dataset is driven by Medicare patients. Analysts should treat this profile as a Medicare‑centric practice when assessing payer mix, access, and patient-panel characteristics.

Revenue is concentrated in a small set of services: the precomputed top 3 Medicare codes by revenue account for 47.6% of this provider's total Medicare revenue, driven primarily by 99213 ($111.3K, 19.6%), 17311 ($107.7K, 19.0%), and 17000 ($51.1K, 9.0%). This concentration indicates that routine office visits plus lesion excision/destruction and Mohs surgery together make up nearly half of billed Medicare revenue.

The CPT mix identifies a procedural dermatology practice that combines high office‑visit throughput with skin cancer treatment and lesion management: high‑revenue codes include 99213 (office visits), 17311/17312 (Mohs surgery), and lesion destruction codes 17000/17003/17004, alongside biopsy codes 11102/11103 and excision codes 11602. Together these codes indicate a service line focused on diagnosis and in‑office surgical treatment of skin lesions, with ancillary reconstructive repairs (13132, 14060, 15260) supporting surgical workflows.

99213 shows an unusually large office‑visit volume relative to peers: it ranks #1178 of 457151 providers nationally and is labeled an "extreme outlier," signaling far higher Medicare visit volume than typical dermatology providers. This level of E/M billing suggests significant ambulatory throughput or a large established patient panel driving Medicare revenue.

Several procedure codes are statistical outliers for volume, reinforcing a high‑throughput procedural practice: 17000 ranks #354 of 21879 providers nationally (98th percentile; "extreme outlier") and the add‑on 17003 reports 5K claims and ranks #332 of 19643 (98th percentile; "notably above typical national volume"). These patterns point to frequent destruction of premalignant lesions and very high lesion counts per encounter compared with national peers.

Mohs surgery contributes materially but at a typical specialist level: 17311 generated $107.7K (19.0% of Medicare revenue) and ranks #1408 of 2969 providers nationally (52th percentile; "typical, unremarkable volume"). In other words, the provider performs Mohs regularly but does not rank among the highest‑volume Mohs surgeons nationally.

The practice captures ancillary procedural and pathology revenue that supports on‑site diagnosis and therapies: 88305 yields $39.5K (7.0%) and ranks in the 65th percentile ("typical, unremarkable volume"), while photodynamic/ALA products appear in the mix (J7308 $14.3K, 74th percentile; J7345 $3K, 11th percentile). These entries indicate in‑office specimen processing and use of topical photodynamic agents as part of treatment options.

Provider tenure is established: NPI enumerated on 2012-04-12 (~14 years ago), consistent with a mature practice profile that has built Medicare billing patterns over multiple years. Combined with concentrated revenue streams and high procedural volumes, the tenure supports a stable, procedure‑oriented dermatology operation rather than a new or incidental Medicare biller.

Medicare: Complete Services Breakdown

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

35 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…	1,820	$60	$111.3K
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	250	$440	$107.7K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	1,350	$40	$51.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	770	$50	$39.5K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	490	$70	$34.4K
17003	In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through…	5,020	$10	$25.1K
17004	The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others.	180	$120	$22K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	120	$180	$21.1K
14060	The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.	30	$590	$18.3K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	50	$320	$16.7K

Showing 1–10 of 35

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 35 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Wallace Smith — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

35 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	16	40	160	$410	$86.3K
17312	23	40	70	$280	$31.3K
88305	42	150	360	$40	$23.4K
15260	11	20	20	$680	$14.3K
14060	6	30	20	$540	$13K
99214	909	4,080	80	$80	$11.6K
J7308	3	10	30	$290	$10.4K
13132	4	40	40	$200	$10.1K
17004	11	110	50	$110	$9.9K
14040	14	10	20	$470	$9.8K

Showing 1–10 of 35

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bradley Evanson	UT	Dermatology Physician	$465.7K	$0
Greg Jacobsen	UT	Dermatology Physician	$415K	$0
W Smith	UT	Dermatology Physician	$127.9K	$0
Rand Colbert	UT	Dermatology Physician	$102.4K	$710
Scott Condie	UT	Physician Assistant	$86.6K	$0
Darin Smith	UT	Physician Assistant	$85.8K	$0
Marcus Pace	NV	Physician Assistant	$68.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Logistics, LLC.	UT	Transportation Broker	$0	$299.6M
Southwest Center	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$58.3M
Red Rock Healthcare, Inc.	UT	Home Health Agency	$0	$27.3M
Virgin River Healthcare, Inc.	UT	In Home Supportive Care Agency	$0	$13.3M
Crimson Heights LLC	UT	Community/Behavioral Health Agency	$0	$7.8M
Southwest Center	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$7.7M
Crimson Heights LLC	UT	Behavior Analyst	$0	$6.8M
Washington County School District	UT	Local Education Agency (LEA)	$0	$6.8M
Red Mesa Home Care	UT	Home Health Agency	$0	$4M
The Learning Center For Families	UT	Developmentally Disabled Services Day Training Agency	$0	$3.9M

Wallace Smith — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References