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

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

Emily Appleton (NPI 1407811102)

Field	Value
Entity Type	Individual
Organization	Emily Appleton
Address	35 Walker St
City	Kittery
State	ME
ZIP	03904
Taxonomy	Physician Assistant
NPI Enumerated	April 18, 2006

Payer Source	Total Paid
Medicare	$27.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 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…	280	$60	$15.8K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	80	$110	$8.4K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	80	$20	$1.8K
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…	30	$30	$930
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,…	20	$20	$350

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Emily Appleton — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	186	2,500	70	$70	$7.2K
G0439	190	650	50	$70	$4.3K
99213	1,621	2,350	50	$50	$4.3K
95251	10	30	70	$20	$1.7K
99212	315	410	30	$30	$1.5K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
York Hospital	PA	Family Medicine Physician	$0	$6.2M
York Hospital	ME	General Acute Care Hospital	$0	$5.8M
George Gentchos	NJ	Diagnostic Radiology Physician	$335.4K	$0
Brian Keroack	ME	Specialist	$326.6K	$0
Edward Fels	ME	Specialist	$266.6K	$0
Peter Dourdoufis	NH	Cardiovascular Disease Physician	$254.4K	$0
Jeffrey Colnes	ME	Cardiovascular Disease Physician	$226K	$0
Julie Suarez	NH	Internal Medicine Physician	$175.2K	$0
Joshua Keller	ME	Rheumatology Physician	$175K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paul Lalicata	ME	Denturist	$0	$455.9K
Brett Rankin	ME	Otolaryngology Physician	$153K	$0
Christopher Sarno	ME	Otolaryngology Physician	$108.4K	$0
Kevin Webb	ME	Optometrist	$78.9K	$0
Nicholas Coppins	ME	Family Medicine Physician	$77K	$0
Nathan Jean	ME	Family Medicine Physician	$62.1K	$0
Tyler Lowe	ME	Optometrist	$56.9K	$0
Karen Healy	ME	Optometrist	$56.1K	$0
Heather Moher	ME	Family Medicine Physician	$51.7K	$0
Philip Abraham	ME	Internal Medicine Physician	$45.9K	$0

Emily Appleton — Billing Profile & Reimbursement Data

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Emily Appleton — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References