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

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

Nicole Sedano (NPI 1417400136)

Field	Value
Entity Type	Individual
Organization	Nicole Sedano
Address	3700 Park East Dr
City	Beachwood
State	OH
ZIP	44122
Taxonomy	Adult Health Nurse Practitioner
NPI Enumerated	July 28, 2016

Payer Source	Total Paid
Medicare	$72.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	700	$50	$33.7K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	400	$70	$27.3K
99316	The provider sees a patient for nursing facility discharge management requiring more than 30 minutes.	130	$90	$10.8K
99315	The provider sees a patient for nursing facility discharge management requiring 30 minutes or less.	10	$50	$640

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

Nicole Sedano — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	373	1,450	180	$70	$21.8K
99308	153	1,340	150	$50	$15.3K
99316	6	250	30	$90	$3.4K
99315	105	120	20	$60	$2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Primary Care Practices Inc	OH	Internal Medicine Physician	$0	$78.7M
Pearl's Hope, LLC	OH	Home Health Agency	$0	$47.8M
Health Care Bridge, Inc	OH	Home Health Agency	$0	$32.3M
Cleveland Clinic Health System - East Region	OH	General Acute Care Hospital	$0	$31.5M
Altimate Care LLC	OH	Home Health Agency	$0	$24M
Signature Health, Inc	OH	Federally Qualified Health Center (FQHC)	$0	$23M
University Hospitals Ahuja Medical Center, Inc	OH	General Acute Care Hospital	$0	$21.1M
Shaker Clinic, LLC	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.5M
Psychological & Behavioral Consultants, LLC	OH	Psychiatry Physician	$0	$14.9M
Northeast Home Health Services	OH	Home Health Agency	$0	$11.9M

Nicole Sedano — Billing Profile & Reimbursement Data

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Nicole Sedano — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References