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

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

Carlos Ching (NPI 1417543117)

Field	Value
Entity Type	Individual
Organization	Carlos Ching
Address	1520 W Sunrise Dr
City	Phoenix
State	AZ
ZIP	85041
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 16, 2020

Payer Source	Total Paid
Medicare	$62.9M
Medicaid	$0

Key Findings

This provider reports $62.9M in lifetime Medicare revenue and none (no Medicaid billing on file), making its commercial payer footprint effectively single-payer Medicare. Precomputed metrics show the top 3 Medicare codes account for 100.0% of this provider's total Medicare revenue, indicating an unusually concentrated Medicare revenue base.

Medicare revenue is overwhelmingly driven by a single code: Q4262 accounts for $62.9M and 99.9% of Medicare revenue, with 68.3K claims and an average paid per claim of $921. That extreme concentration around Q4262 creates high exposure to reimbursement or coding changes affecting this single line item.

The code mix (Q4262 plus the 1527x skin substitute series) points to a focused wound-care and skin-substitute service line: Q4262 is a dual layer impax membrane product and 15273/15274 describe skin substitute grafting for trunk/limb wounds. This pattern suggests the provider’s operations are centered on application and billing for biologic membranes and graft materials rather than a broad primary-care panel, despite the listed taxonomy of Family Nurse Practitioner.

Q4262 is a national outlier for volume and revenue: it ranks #4 of 141 providers nationally (98th percentile; extreme outlier), which signals a dominant national standing for that specific supply/procedure code. By contrast, 15273 ranks #6 of 43 (88th percentile; notably above typical national volume) and 15274 ranks #11 of 46 (78th percentile; typical, unremarkable volume), indicating the secondary skin-substitute services are above-average but much smaller in dollar impact.

At the claims level there is a stark imbalance: Q4262 shows 68.3K claims at $921 average paid/claim for $62.9M in revenue, while 15274 and 15273 show 414 claims ($54 avg paid/claim, $22.4K revenue) and 125 claims ($162 avg paid/claim, $20.3K revenue) respectively. Those figures emphasize that the provider’s Medicare activity is dominated by very high-volume supply/procedure billing for Q4262, with the other codes contributing negligible dollars by comparison.

The provider’s NPI was enumerated on 2020-12-16 (~6 years ago), indicating a relatively recent enrollment date to achieve the reported volume; the pace and scale of Medicare billing since enumeration are notable given that timeframe. This rapid build-up in a narrow set of codes may warrant operational review when assessing sustainability of revenue patterns.

From a payer-analytics and contracting perspective, the absence of any Medicaid billing on file combined with near-total reliance on Q4262 for Medicare revenue concentrates both payer and code-level risk. For network or utilization management teams, this profile flags a specialized supplier-like relationship with Medicare rather than a diversified clinical practice, which has implications for audit focus, reimbursement negotiations, and contingency planning if coverage or coding for Q4262 were to change.

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
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	68,310	$920	$62.9M
15274	The provider uses a skin substitute such as an allograft or xenograft to cover a trunk, arms, and/or legs wound surface area of up to an additional 100 cm2 in a patient 10 years or older, or 1…	410	$50	$22.4K
15273	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs that are greater than or equal to 100 cm2. This code covers the first…	130	$160	$20.3K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	100	$100	$9.7K
15272	At the same session that the provider uses a skin substitute, such as an allograft or xenograft, to cover the wounds on the patient’s trunk, arms, and/or legs up to an area of 100 scm2, the provider…	180	$20	$2.8K

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. Arizona Distribution

Carlos Ching — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	4	10	31,870	$890	$43.9M
15274	4	10	310	$60	$22.8K
15273	4	10	130	$150	$22.4K
15271	16	40	90	$100	$10.8K
15272	1	10	110	$20	$1.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Path Of Resilience - Aprbhs - Rose House - LLC	AZ	Community/Behavioral Health Agency	$0	$48.7M
Maricopa County Special Health Care District	AZ	Federally Qualified Health Center (FQHC)	$0	$19.6M
Maricopa County Special Health Care District	AZ	Federally Qualified Health Center (FQHC)	$0	$15.4M
Cactus Wren Community Services LLC	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$10.3M

Carlos Ching — 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