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

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

Karen Heidelberg (NPI 1467406439)

Field	Value
Entity Type	Individual
Organization	Karen Heidelberg
Address	20400 Livernois Ave
City	Detroit
State	MI
ZIP	48221
Taxonomy	Dermatology Physician
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicare	$203K
Medicaid	$0

Medicare: Complete Services Breakdown

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

11 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…	830	$90	$77.9K
11901	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	1,050	$50	$52.4K
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…	630	$70	$41.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	790	$10	$7.8K
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…	60	$120	$6.7K
11104	The provider biopsies a skin lesion using a punch technique with a sharp hollow instrument; punch biopsies are commonly performed for deeper circular skin lesions.	50	$90	$4.3K
11900	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	110	$40	$3.9K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	40	$80	$3.4K
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…	30	$70	$2.4K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,260	$1	$1.3K

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Karen Heidelberg — 6 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	239	15,470	80	$80	$11.4K
17110	471	660	80	$70	$8.6K
99213	289	14,810	60	$60	$6.6K
11901	1	50	60	$50	$4.8K
99204	1,283	6,280	30	$110	$4.2K
99203	1,914	4,560	30	$70	$3K
11104	10	140	20	$80	$2.2K
11900	5	150	30	$30	$1.2K
96372	11	1,710	40	$10	$830
J3301	69	1,010	150	$1	$300

Showing 1–10 of 11

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Detroit Family Home	MI	Custodial Care Facility	$0	$15.9M
Charles Johnson	MI	Podiatrist	$24.6K	$0

Karen Heidelberg — Billing Profile & Reimbursement Data

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Karen Heidelberg — 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