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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Thomas Johnson (NPI 1467433342)

Field	Value
Entity Type	Individual
Organization	Thomas Johnson
Address	100 Hitchcock Way
City	Manchester
State	NH
ZIP	03104
Taxonomy	Pediatric Cardiology Physician
NPI Enumerated	November 8, 2005

Payer Source	Total Paid
Medicare	$9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	40	$80	$3K
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…	40	$70	$2.7K
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…	10	$130	$1.9K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	40	$20	$740
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	40	$10	$270
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	20	$10	$220
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	20	$10	$140

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Thomas Johnson — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,388	3,150	110	$80	$13.2K
99215	969	1,080	40	$110	$6.8K
93303	1	10	40	$80	$3K
93010	201	270	90	$10	$2.2K
93000	123	210	30	$10	$810
93320	17	40	40	$10	$690
93325	44	80	50	$1	$200

Thomas Johnson — Billing Profile & Reimbursement Data

Sign up for Thomas Johnson — Billing Profile & Reimbursement Data policy alerts

Thomas Johnson — Billing Profile & Reimbursement Data

Sign up for Thomas Johnson — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References