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

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

James Price (NPI 1477059178)

Field	Value
Entity Type	Individual
Organization	James Price
Address	435 Lewis Ave
City	Meriden
State	CT
ZIP	06451
Taxonomy	Emergency Medicine Physician
NPI Enumerated	April 2, 2018

Payer Source	Total Paid
Medicare	$84.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	320	$140	$44.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	150	$170	$26.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	120	$90	$11.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	320	$10	$1.9K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	10	$30	$320

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Connecticut Distribution

James Price — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	51	800	90	$140	$17.7K
99291	83	1,130	40	$180	$10.6K
99284	141	860	60	$90	$6.6K
93010	187	450	210	$10	$3K
12001	4	10	10	$40	$530

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Century Integrated Partners, Inc	TX	Emergency Medicine Physician	$0	$27.8M
Robert Collier	TX	Emergency Medicine Physician	$180K	$0
Jonathan Holt	TX	Emergency Medicine Physician	$176.1K	$0
Humza Azam	TX	Emergency Medicine Physician	$154.3K	$0
Harold Jimenez	TX	Emergency Medicine Physician	$153.9K	$0
Ashton Hudson	KY	Emergency Medicine Physician	$120.7K	$0
Joshua Diviney	TX	Emergency Medicine Physician	$99.5K	$0
Vimal Shenoy	WA	Emergency Medicine Physician	$72.1K	$0
Jesal Amin	MO	Emergency Medicine Physician	$69.8K	$610
Bradley Gao	AK	Emergency Medicine Physician	$61.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midstate Medical Center	CT	General Acute Care Hospital	$0	$110.8M
Hunter's Ambulance Service, Inc.	CT	Ambulance	$4.2M	$25.5M
Emergency Medicine Physicians Of New Haven County,llc	CT	Emergency Medicine Physician	$0	$8.6M
Midstate Gastroenterology Specialists PC	CT	Gastroenterology Physician	$0	$6.6M
Midstate Radiology Associates, LLC	CT	Diagnostic Radiology Physician	$0	$6.6M
Nems PLLC	CT	Emergency Medicine Physician	$0	$6.1M
B.e.k Eyecare, Inc	CT	Optometrist	$0	$3.7M
Apple Dental And Associates,llc	CT	General Practice Dentistry	$0	$2.1M
Connecticut Counseling Centers, Inc	CT	Methadone Clinic	$0	$2M
Franciscan Family Care Center, Inc.	CT	Home Health Agency	$0	$1.8M

James Price — Billing Profile & Reimbursement Data

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James Price — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References