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

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

Girish Patel (NPI 1447314190)

Girish Patel is a internal medicine physician provider located in North Port, Florida. This profile covers 61 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	Girish Patel
Address	2500 Bobcat Village Center Rd,
City	North Port
State	FL
ZIP	34288
Taxonomy	Internal Medicine Physician
NPI Enumerated	December 20, 2006

Payer Source	Total Paid
Medicare	$328K
Medicaid	$0

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

61 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	940	$90	$80K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	580	$60	$37.2K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	170	$130	$21.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	150	$130	$19.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	200	$100	$19.2K
82172	The lab analyst performs apolipoprotein testing on components of lipoprotein complexes that contain a variety of high, low, and very–low density lipoproteins. The three most important of these…	570	$20	$11.9K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	160	$60	$10.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	80	$90	$7.2K
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…	140	$50	$7.1K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	170	$40	$6.6K

Showing 1–10 of 61

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
82172	20	50	370	$20	$25.9K
99214	2,088	32,760	140	$90	$25K
82306	244	920	70	$30	$21.5K
80053	434	1,430	170	$10	$21.3K
84443	290	1,210	130	$20	$20.9K
83970	81	320	50	$40	$20.2K
99233	3,082	9,970	100	$90	$20.1K
99490	917	1,200	150	$50	$19.7K
80061	350	1,250	160	$10	$19.4K
82670	41	70	70	$30	$19.1K

Girish Patel — Billing Profile & Reimbursement Data

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Girish Patel — 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