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

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

James Krumholz (NPI 1427785286)

Field	Value
Entity Type	Individual
Organization	James Krumholz
Address	79 E Center St
City	Bountiful
State	UT
ZIP	84010
Taxonomy	Physical Therapist
NPI Enumerated	August 2, 2022

Payer Source	Total Paid
Medicare	$83.9K
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
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	1,090	$20	$22.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	940	$20	$22.6K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	1,100	$20	$18.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,060	$20	$18K
97163	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history of a patient with three or more personal factors that may affect care, assess a clinical…	30	$70	$2.3K

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. Utah Distribution

James Krumholz — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	137	640	410	$20	$13.3K
97530	51	370	290	$20	$12.1K
97112	46	400	290	$20	$10.2K
97116	5	70	130	$20	$5.6K
97163	21	80	20	$70	$3.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bcbu, Inc.	UT	Home Health Agency	$0	$10.2M
Vali Division Of Wasatch, Inc	UT	Community Based Hospice Care Agency	$0	$8.4M
Hospital Corporation Of Utah	UT	General Acute Care Hospital	$0	$6M
South Davis Metro Fire Service Area	UT	Land Ambulance	$317.9K	$3.3M
Ryan K Anderson D P M P C	UT	Foot & Ankle Surgery Podiatrist	$0	$3.5M
Rocky Mountain Personal Care LLC	UT	In Home Supportive Care Agency	$0	$3M
Providential Bba Operating LP	UT	Home Health Agency	$0	$1.7M
Tautai Barton Creek, LLC	UT	Assisted Living Facility	$0	$1.5M
Mg Bountiful Subtenant LLC	UT	Assisted Living Facility	$0	$1.3M
Neurobehavioral Center For Growth LLC	UT	Psychologist	$0	$1.2M

James Krumholz — 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