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.

Thomas Jones (NPI 1467980441)

Field	Value
Entity Type	Individual
Organization	Thomas Jones
Address	1500 E Sherman Blvd
City	Muskegon
State	MI
ZIP	49444
Taxonomy	Physician Assistant
NPI Enumerated	June 2, 2017

Payer Source	Total Paid
Medicare	$7.1K
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
35301	The provider removes thrombus and plaques from a carotid, vertebral, or subclavian artery through a neck incision.	20	$120	$2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	50	$30	$1.4K
36832	In this procedure, the provider surgically opens an autogenous or nonautogenous arteriovenous fistula and revises the connection between the artery and the vein often located in the upper arm or…	20	$80	$1.3K
36830	In this procedure, the provider surgically creates an arteriovenous fistula, a connection between an artery and a vein using a nonautogenous graft. This service is done to allow for hemodialysis…	10	$70	$870
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20	$50	$780
36821	The provider creates an arteriovenous (AV) anastomosis by connecting a vein to an artery in any site to provide better vascular access in a patient with kidney failure who will receive hemodialysis…	10	$60	$770

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. Michigan Distribution

Thomas Jones — 0 of 6 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

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36830	6	10	20	$830	$14K
35301	5	10	20	$720	$12.2K
36821	12	20	20	$610	$12.1K
99232	6,484	6,730	90	$60	$12K
36832	2	10	20	$660	$11.9K
99231	818	2,000	40	$40	$2.6K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Thomas Jones, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawrence Mallon	MI	Vascular Surgery Physician	$130.9K	$0
Justin Eisenberg	MI	Vascular Surgery Physician	$112.5K	$0
Stephen Zonca	MI	Plastic and Reconstructive Surgery Physician	$36.6K	$0
Srdjan Ostric	MI	Plastic Surgery Physician	$30.4K	$0
Ryan Terlouw	MI	Plastic Surgery Physician	$25.8K	$0
Lori Baerman	MI	Certified Registered Nurse Anesthetist	$40	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Moka Corporation	MI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$126.2M
Mercy Health Partners	MI	General Acute Care Hospital	$0	$98.1M
Senior Resources Of West Michigan	MI	Case Management Agency	$0	$31.5M
Mgh Family Health Center	MI	Federally Qualified Health Center (FQHC)	$0	$24.4M
Hackley Community Care Center Inc	MI	Federally Qualified Health Center (FQHC)	$0	$23.1M
Orthopaedic Associates Of Muskegon, PC	MI	Orthopaedic Surgery Physician	$0	$7.1M
Port City Pediatrics	MI	Pediatrics Physician	$0	$5.9M
Radiology Muskegon PC	MI	Diagnostic Radiology Physician	$0	$5.9M
Mercy Specialty Services	MI	Internal Medicine Physician	$0	$5.3M
Paul Raphaelian	MI	Retina Specialist (Ophthalmology) Physician	$1.5M	$0

Thomas Jones — Billing Profile & Reimbursement Data

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

Thomas Jones — Billing Profile & Reimbursement Data

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

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References