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

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

Jane Miller (NPI 1437239423)

Jane Miller is a urology physician provider located in Seattle, Washington. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Jane Miller
Address	University Of Washington Medical Ctr
City	Seattle
State	WA
ZIP	98195
Taxonomy	Urology Physician
NPI Enumerated	October 16, 2006

Payer Source	Total Paid
Medicare	$21.6K
Medicaid	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	60	$50	$3.1K
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…	30	$80	$2.5K
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…	20	$120	$2.5K
52287	The provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystoscope. He then inserts a needle and injects a neurolytic drug into the…	20	$130	$2.2K
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…	20	$100	$2.2K
51728	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies to diagnose certain urinary disorders like an overactive bladder, stress incontinence, or urinary…	30	$80	$2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	70	$30	$1.8K
99205	The provider sees a new 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 provider…	10	$160	$1.7K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	20	$60	$1.4K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	10	$60	$830

Showing 1–10 of 14

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
52000	160	180	90	$140	$14.4K
99214	8,842	10,860	100	$80	$13.6K
52287	42	50	20	$310	$11.4K
51728	24	40	30	$220	$8.5K
99215	3,086	4,320	40	$120	$8.4K
99213	4,676	9,690	60	$60	$6.5K
99205	1,725	1,820	30	$150	$5.4K
99204	3,107	4,750	30	$110	$5.2K
51797	22	40	20	$110	$3.7K
99203	2,612	3,140	30	$70	$3.3K

Jane Miller — Billing Profile & Reimbursement Data

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Jane Miller — 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