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

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Rachel Card (NPI 1447714548)

Field	Value
Entity Type	Individual
Organization	Rachel Card
Address	67 Victoria Street
City	Hamilton
State	XX (Unspecified Location)
ZIP	HM 17
Taxonomy	Family Nurse Practitioner
NPI Enumerated	January 23, 2019

Payer Source	Total Paid
Medicare	$5.3K
Medicaid	$0

Key Findings

Scale and payer mix: This provider has a very small Medicare footprint with total Medicare revenue of $5.3K and no Medicaid billing on file, making the practice effectively single‑payer (Medicare) in the dataset. The absence of any Medicaid activity suggests limited exposure to state programs or that Medicaid billing is handled elsewhere or not performed.

Revenue concentration: The provider’s Medicare revenue is highly concentrated — the precomputed top three codes account for 100.0% of total Medicare revenue, driven by 99442 (54.0%), 99213 (30.9%), and 99214 (15.2%). Those three codes together fully explain the provider’s Medicare receipts, indicating a narrow set of billable services.

Service-line implications: The code mix is dominated by evaluation-and-management activity: 99213 and 99214 are established-patient office/outpatient visits (low and moderate complexity, respectively), and 99442 is the single largest revenue driver. This pattern suggests the clinician’s work focuses on routine outpatient management of established patients with a notable component of non-procedural encounters.

Utilization and unit payments: Claim volumes and unit payments are modest — 99442 appears on 70 claims with $41 avg paid/claim and $2.9K revenue, 99213 on 41 claims with $40 avg paid/claim and $1.6K revenue, and 99214 on 13 claims with $62 avg paid/claim and $806 revenue. These figures indicate relatively low per‑claim payments and limited encounter volume consistent with the overall $5.3K Medicare total.

Competitive standing by code: National ranking and dataset labels do not portray the provider as a dominant national player for these codes. 99442 ranks #3001 of 21242 providers nationally (86th percentile) and is described in the dataset as "typical, unremarkable volume for this code"; 99213 ranks #311307 of 457151 (31th percentile) and is labeled "typical, unremarkable volume for this code"; 99214 ranks #466550 of 479517 (2th percentile) and is likewise labeled "typical, unremarkable volume for this code."

Statistical outliers and variability: None of the top codes are flagged as outliers in the provided descriptors — all three top codes carry the plain‑English label "typical, unremarkable volume for this code," suggesting no anomalous billing patterns by the dataset’s standards. This implies expected variation rather than exceptional or atypical activity.

Tenure/network presence: The provider’s NPI was enumerated on 2019-01-23 (~7 years ago), so this profile reflects a relatively recent but multi-year presence in Medicare billing. Given the small lifetime Medicare revenue, this tenure has not translated into large Medicare billing volume.

Operational implications for payers and network analysts: With only $5.3K in Medicare revenue, no Medicaid claims, and revenue fully concentrated in three E/M codes, this clinician represents a low‑volume, outpatient E/M resource. Analysts evaluating network value or contracting should consider the provider’s limited scale and focused service mix (established-patient visits and telephone/remote encounters) when assessing fit for managed care panels or referral networks.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99442	N/A	70	$40	$2.9K
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…	40	$40	$1.6K
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…	10	$60	$810

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Unspecified Location Distribution

Rachel Card — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	8	10	140	$60	$18.8K
99214	19	10	80	$90	$15.8K
99442	1	10	10	$50	$590

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rachel Card, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Planning Association Of Maine Inc	ME	Non-Surgical Family Planning Clinic/Center	$0	$2.8M

Rachel Card — Billing Profile & Reimbursement Data

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Rachel Card — 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

Related Providers

Frequently Asked Questions

References