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

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

Benjamin Jones (NPI 1427619113)

Field	Value
Entity Type	Individual
Organization	Benjamin Jones
Address	12605 E 16th Ave
City	Aurora
State	CO
ZIP	80045
Taxonomy	Surgical Physician Assistant
NPI Enumerated	June 24, 2019

Payer Source	Total Paid
Medicare	$2.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
32669	This procedure involves visualizing the chest cavity and the lung in order to excise a segment of the lung.	10	$150	$2.1K
32674	This procedure involves visualizing the chest cavity and the mediastinal lymph nodes in order to remove them.	20	$20	$500

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Benjamin Jones — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
32669	1	10	10	$150	$2.1K
32674	4	10	20	$110	$1.9K

Benjamin Jones — Billing Profile & Reimbursement Data

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Benjamin Jones — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References