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

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

Edward Douglas (NPI 1467452813)

Field	Value
Entity Type	Individual
Organization	Edward Douglas
Address	3829 S Jefferson Ave
City	Springfield
State	MO
ZIP	65807
Taxonomy	Neuromusculoskeletal Medicine & OMM Physician
NPI Enumerated	July 28, 2005

Payer Source	Total Paid
Medicare	$119.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 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…	1,050	$60	$62.8K
98928	The provider performs controlled manual pressure in seven to eight body regions to treat somatic and nonsomatic disorders.	690	$50	$33.8K
98927	The provider performs controlled manual pressure in five to six body regions to treat somatic and nonsomatic disorders.	380	$40	$15.7K
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	$40	$2.9K
98926	The provider performs controlled manual pressure in three to four body regions to treat somatic and nonsomatic disorders.	70	$30	$2.1K
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	$2.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Missouri Distribution

Edward Douglas — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,646	8,960	100	$80	$13.9K
99213	74	8,730	70	$50	$7K
98928	1	20	80	$50	$6.6K
98927	1	20	100	$40	$5.2K
98926	10	20	40	$30	$2.5K
99212	431	1,930	30	$30	$2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Supported Living And Employment Services, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$276.6M
Easy Living Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$183.2M
Lester E Cox Medical Centers	MO	General Acute Care Hospital	$0	$112.3M
Healthcare Services Of The Ozarks, Inc	MO	Home Health Agency	$0	$60.3M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Abilities First	MO	Case Management Agency	$0	$45.8M
Southwest Center For Independent Living	MO	In Home Supportive Care Agency	$0	$45.3M
Lester E Cox Medical Centers	MO	Land Ambulance	$0	$25.8M
Seniorage Area Agency On Aging	MO	Case Management Agency	$0	$19.2M
Maxim Healthcare Services, Inc.	MO	Home Health Agency	$0	$17.7M

Edward Douglas — Billing Profile & Reimbursement Data

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Edward Douglas — 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