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

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

Jeremy Ryan Pena (NPI 1467688960)

Field	Value
Entity Type	Individual
Organization	Jeremy Ryan Pena
Address	55 Fruit St
City	Boston
State	MA
ZIP	02114
Taxonomy	Clinical Pathology Physician
NPI Enumerated	June 10, 2009

Payer Source	Total Paid
Medicare	$7.5K
Medicaid	$0

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
80504	At the request of a physician or other qualified healthcare provider, the pathologist performs a consultation for a moderately complex clinical problem requiring a moderate level of medical judgment…	70	$40	$2.7K
80503	At the request of a physician or other qualified healthcare provider, the pathologist performs a consultation for a clinical problem requiring straightforward medical judgment to help clarify…	140	$20	$2.4K
80505	At the request of a physician or other qualified healthcare provider, the pathologist performs a consultation for a highly complex clinical problem requiring a high level of medical judgment to help…	30	$80	$2.3K

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.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Jeremy Ryan Pena — 2 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80504	1	10	60	$40	$2.2K
80505	1	10	20	$70	$1.8K
80503	3	10	40	$20	$1.3K

Jeremy Ryan Pena — Billing Profile & Reimbursement Data

Sign up for Jeremy Ryan Pena — Billing Profile & Reimbursement Data policy alerts

Jeremy Ryan Pena — Billing Profile & Reimbursement Data

Sign up for Jeremy Ryan Pena — 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