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

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

Tina Williams (NPI 1376894840)

Field	Value
Entity Type	Individual
Organization	Tina Williams
Address	1520 Slate Creek Rd Suite 205
City	Grundy
State	VA
ZIP	24614
Taxonomy	Family Nurse Practitioner
NPI Enumerated	September 25, 2012

Payer Source	Total Paid
Medicare	$12.5K
Medicaid	$0

Key Findings

This provider’s Medicare activity is tightly concentrated in standard outpatient evaluation-and-management visits: 99213 and 99214 together account for 100.0% of the provider’s Medicare revenue, with 99213 alone representing 75.3% and 99214 representing 24.7% of Medicare revenue. The code descriptions indicate low- to moderate-complexity established-patient office visits, consistent with a primary-care or longitudinal outpatient practice by a Family Nurse Practitioner.

Medicare revenue is modest in absolute terms: total Medicare revenue is $12.5K, with $9.4K attributable to 99213 (261 claims, $36 avg paid/claim) and $3.1K to 99214 (54 claims, $57 avg paid/claim). The claims mix (many more 99213 visits than 99214 visits) and the lower average payment per claim for 99213 suggest a high-volume of shorter/less-complex established visits rather than a procedure-heavy caseload.

The provider has no Medicaid billing on file (none below), making the practice effectively single-payer in the dataset reviewed. Analysts should treat the entity as Medicare-focused for the available claims period rather than as a mixed Medicare–Medicaid provider.

Competitive standing for the dominant code is mixed: 99213 ranks #71742 of 457151 providers nationally (84th percentile; typical, unremarkable volume for this code), indicating this provider bills 99213 at a level above many peers but is still described as a typical, unremarkable volume profile. For 99214 the provider ranks #329336 of 479517 providers nationally (31th percentile; typical, unremarkable volume for this code), showing lower relative activity on higher-complexity E/M visits.

Operational implication: the absence of procedure or specialty codes in the top revenue lines and the exclusive concentration in 99213/99214 imply the provider operates as an office-based primary care clinician focused on established-patient management and routine follow-up care. This pattern is consistent with a Family Nurse Practitioner scope centered on ambulatory evaluation-and-management rather than procedural services.

Tenure data show the NPI was enumerated on 2012-09-25 (~14 years ago), indicating an established presence in billing registries; despite this longevity, current Medicare revenue levels ($12.5K) remain small, which may reflect a part-time practice, limited Medicare panel, or recent changes in caseload rather than a new entrant.

The revenue-per-claim split—$36 avg paid/claim for 99213 versus $57 avg paid/claim for 99214—combined with the 261 vs. 54 claim counts, underscores a visit mix skewed toward lower-intensity encounters. For payer strategy or network analyses, this suggests the provider is likely to contribute routine chronic-care follow-up volume rather than high-acuity or procedure-driven revenue streams.

Medicare: Complete Services Breakdown

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

2 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…	260	$40	$9.4K
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…	50	$60	$3.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Virginia Distribution

Tina Williams — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	9	12,890	140	$80	$21K
99213	5	12,440	90	$60	$10K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Buchanan General Hospital, Inc	VA	General Acute Care Hospital	$0	$11.2M
Carl Hackney	VI	Dentist	$0	$1.1M
Madhava Pally	VA	Cardiovascular Disease Physician	$113.1K	$0
Susan Mullooly	VA	Emergency Medicine Physician	$70.6K	$0
Jenny Cole	VA	Family Nurse Practitioner	$24.7K	$0

Tina Williams — Billing Profile & Reimbursement Data

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Tina Williams — 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

Nearby Providers

Frequently Asked Questions

References