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

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

Candace Pratt (NPI 1477754240)

Field	Value
Entity Type	Individual
Organization	Candace Pratt
Address	111 S. 11th Street
City	Philadelphia
State	PA
ZIP	19107
Taxonomy	Certified Registered Nurse Anesthetist
NPI Enumerated	May 30, 2007

Payer Source	Total Paid
Medicare	$21.5K
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
00731	The anesthesia provider performs anesthesia services for an unspecified type of upper gastrointestinal endoscopic procedure during which another provider introduces the endoscope to but not beyond…	160	$60	$9.9K
00732	The anesthesia provider performs anesthesia services for an endoscopic retrograde cholangiopancreatography (ERCP) during which another provider introduces the endoscope to the proximal (upper) part…	40	$110	$4.6K
00811	The provider performs anesthesia services for a patient undergoing an unspecified lower intestinal endoscopic procedure where the surgical provider introduces an endoscope into the intestines up to…	60	$60	$3.9K
00813	The anesthesia provider performs anesthesia services for a patient undergoing both upper and lower intestinal endoscopy where the surgical provider introduces an endoscope into the intestines above…	40	$60	$2.3K
00812	The provider performs anesthesia services for a patient undergoing a screening colonoscopy during which the surgical provider introduces an endoscope into the intestines below the duodenum, the part…	20	$50	$850

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. Pennsylvania Distribution

Candace Pratt — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
00811	265	2,050	20	$70	$2.8K
00812	709	1,070	20	$70	$2.7K
00732	8	80	20	$100	$2.3K
00813	117	830	20	$80	$2.2K
00731	27	2,360	20	$70	$2.1K

Candace Pratt — Billing Profile & Reimbursement Data

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Candace Pratt — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References