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

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

Heath Simmons (NPI 1467833947)

Field	Value
Entity Type	Individual
Organization	Heath Simmons
Address	11795 Education St Ste 110
City	Auburn
State	CA
ZIP	95602
Taxonomy	Physician Assistant
NPI Enumerated	June 10, 2015

Payer Source	Total Paid
Medicare	$92.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

17 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…	250	$60	$15.9K
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	100	$140	$13.2K
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…	140	$90	$12.3K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	210	$50	$10.6K
J7324	Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose	110	$100	$10.5K
23472	In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider…	40	$160	$6.5K
27130	In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or…	50	$130	$6.4K
J7325	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	640	$10	$4.5K
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…	30	$100	$2.8K
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	$80	$2.4K

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Heath Simmons — 0 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	68	820	30	$1,110	$48.9K
27130	117	540	30	$1,070	$40.8K
23472	38	190	20	$870	$26K
99214	17,026	37,970	120	$90	$23.2K
23412	4	10	20	$1,180	$21.2K
J7325	106	110	1,490	$10	$20.2K
J7324	82	180	100	$100	$16.8K
23430	15	60	20	$630	$16.4K
99213	7,320	34,660	80	$70	$13.2K
29824	10	70	20	$430	$9K

Showing 1–10 of 17

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allison Mccormick	CA	Dermatology Physician	$1.5M	$0
James Dunn	CA	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$454.6K	$0
Jeffrey Bergeson	CA	Orthopaedic Surgery Physician	$298.2K	$0
Daniel Binus	CA	Psychiatry Physician	$134.3K	$0
Robert Nordman	CA	Physician Assistant	$104.5K	$0
Raad Al-shaikh	CA	Orthopaedic Surgery Physician	$74.3K	$0
Osama Zahriya	CA	Surgery Physician	$60.4K	$0
Gabriel David	CA	Emergency Medicine Physician	$53.4K	$0
Ian Solari	CA	Sports Medicine (Family Medicine) Physician	$33.8K	$0

Heath Simmons — Billing Profile & Reimbursement Data

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Heath Simmons — 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