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

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

Maria Raines (NPI 1417680083)

Field	Value
Entity Type	Individual
Organization	Maria Raines
Address	117 Ullapool Ct
City	Henderson
State	NV
ZIP	89012
Taxonomy	Primary Care Nurse Practitioner
NPI Enumerated	July 1, 2022

Payer Source	Total Paid
Medicare	$1.1M
Medicaid	$0

Key Findings

This provider has generated $1.1M in lifetime Medicare revenue and reports no Medicaid billing on file (Medicaid revenue: none), making its operations effectively single-payer at the state level. The NPI was enumerated 2022-07-01 (~4 years ago), so these flows represent roughly four years of Medicare activity for a relatively recent entrant.

Revenue is extremely concentrated in a single procedure family: the precomputed top 3 Medicare codes account for 97.5% of this provider’s total Medicare revenue, and Q4173 alone represents $1M or 93.7% of that Medicare revenue. That concentration indicates the practice’s financial performance on Medicare is driven overwhelmingly by reimbursement for Q4173 rather than diversified E/M or ancillary services.

The code mix and service descriptions point to a wound-care and skin-substitute procedural focus rather than a typical primary-care bill mix. High-revenue items include Q4173 (palingen/palingen xplus, $1M), and related wound-care codes appear in the list such as 15271 ($10.2K) and debridement codes 11000 ($6.7K) and 11001 ($900), consistent with a practice model centered on advanced wound treatments and topical skin substitutes.

Despite the very high dollar concentration in Q4173, this provider’s competitive standing for that code is moderate: Q4173 ranks #6 of 19 providers nationally (72th percentile; typical, unremarkable volume for this code), indicating a meaningful presence within a small cohort but not an outlier dominance. For office E/M services, 99214 produced $20.9K (1.9% of Medicare revenue) and ranks #124533 of 479517 nationally (74th percentile; typical, unremarkable volume), suggesting routine ambulatory visit volumes in line with many peers.

Operationally, E/M revenue is a very small share of overall Medicare receipts: 99214 accounts for $20.9K (1.9%) and 99215 for $4.7K (0.4%), which implies the provider bills primarily for procedures and products rather than for high volumes of evaluation-and-management office visits. This pattern is consistent with a procedural/wound-care specialty practice staffed by a Primary Care Nurse Practitioner using advanced products and interventions.

Although Q4173 dominates revenue, other procedure codes show mixed relative activity: 11000 (debridement) ranks #60 of 430 (86th percentile), indicating above-typical relative activity for debridement compared with peers even though it contributes only $6.7K (0.6%) to revenue. By contrast, 97610 (low-frequency ultrasound) produced $22.3K (2.0%) but ranks #245 of 320 (23th percentile; typical, unremarkable volume), showing that some adjunct wound therapies are billed at low percentile standing versus the national sample.

The absence of Medicaid billing on file (Medicaid revenue: none) meaningfully shapes payer mix and contracting implications: the provider has no visible Medicaid footprint to support in-network negotiations or state Medicaid referrals, leaving Medicare as the dominant payer for analysis and network leverage. For payers and health systems evaluating coverage or referral partnerships, this single-payer exposure should be flagged as a structural characteristic of the provider’s book of business.

Tenure and billing profile together suggest a relatively new, procedure-focused practice: NPI enumerated 2022-07-01 (~4 years ago) and immediate heavy reliance on high-revenue procedure code Q4173 implies the provider either joined an existing wound-care site-of-service or rapidly adopted a concentrated product-driven service line after enumeration. Analysts should treat observed Medicare activity as concentrated and potentially sensitive to coding, supply, or contract changes affecting the dominant Q4173 revenue stream.

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4173	Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure)	1,340	$780	$1M
97610	The provider uses a low–frequency ultrasound device to try to improve wound healing.	70	$300	$22.3K
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…	250	$90	$20.9K
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	$10.2K
11000	The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface.	220	$30	$6.7K
99204	The provider sees a new 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 provider…	50	$110	$5.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	40	$120	$4.7K
11001	In this add–on procedure, the provider uses surgical instruments to debride the dead tissue from up to an additional 10 percent of skin after debriding the initial 10 percent at the same encounter.	50	$20	$900

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nevada Distribution

Maria Raines — 0 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4173	2	10	720	$740	$732.5K
97610	9	10	180	$310	$98.4K
99214	1,020	3,610	110	$80	$19K
15271	14	40	80	$110	$17.8K
99215	415	790	40	$120	$12.2K
99204	715	2,010	30	$110	$5.8K
11000	5	10	90	$30	$4.8K
11001	2	10	40	$20	$740

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fresenius Medical Care Nkdhc, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.2M
Oasis Counseling LLC	NV	Mental Health Counselor	$0	$3.1M
Leo Germin	NV	Neurology Physician	$482.3K	$702.3K
Peter Tran	NV	Geriatric Medicine (Family Medicine) Physician	$601.1K	$0
Alexander Imas	NV	Physical Medicine & Rehabilitation Physician	$178.4K	$372.7K
Daniel Batlan	NV	Pain Medicine (Anesthesiology) Physician	$98.7K	$204.6K
Ronald Koe	NV	Orthopaedic Surgery Physician	$286.8K	$0
Daniel Fabito	NV	Pain Medicine (Anesthesiology) Physician	$114.9K	$65.2K
Tarah Snow	NV	Physical Therapist	$136.8K	$0
Leslie Brown	NV	Nurse Practitioner	$95.3K	$0

Maria Raines — Billing Profile & Reimbursement Data

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Maria Raines — 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