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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Kathy Sutton (NPI 1396098794)

Field	Value
Entity Type	Individual
Organization	Kathy Sutton
Address	1750 Lang Pl Ne
City	Washington
State	DC
ZIP	20002
Taxonomy	Professional Counselor
NPI Enumerated	October 23, 2012

Payer Source	Total Paid
Medicaid	$88.9K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	890	$100	$86.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	10	$160	$2K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other District of Columbia providers billing the same CPT/HCPCS codes.

Claims Volume vs. District of Columbia Distribution

Kathy Sutton — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	79	80	370	$130	$124.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	39	100	520	$60	$118.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Government Of The District Of Columbia Office Of Tax And Revenue	DC	Land Ambulance	$5.2M	$213.4M
Rcm Of Washington, Inc	DC	Intellectual Disabilities Intermediate Care Facility	$0	$53.9M
Dcps - Public Schools	DC	Local Education Agency (LEA)	$0	$46.2M
Wellness Health Services, LLC	DC	Home Health Agency	$0	$44.1M
Mcclendon Center	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$31.9M
Office Of The State Superintendent Of Education	DC	Bus	$0	$30.7M
Mt&g Enterprise, Inc	DC	Developmental Disabilities Clinic/Center	$0	$24.3M
D.c. Department Of Behavioral Health	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.7M
Amazing Love Health Services	DC	Community/Behavioral Health Agency	$0	$18.5M
Pathways To Housing Dc	DC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.1M

Kathy Sutton — Billing Profile & Reimbursement Data

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Kathy Sutton — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References