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

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

Emily Jones (NPI 1477916062)

Field	Value
Entity Type	Individual
Organization	Emily Jones
Address	156 Main St
City	Montpelier
State	VT
ZIP	05602
Taxonomy	Family Medicine Physician
NPI Enumerated	March 31, 2016

Payer Source	Total Paid
Medicare	$46.4K
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
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	170	$130	$21.9K
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…	170	$60	$10.8K
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…	130	$50	$5.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	50	$110	$5.6K
G0402	Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	10	$130	$1.5K
G0180	Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review…	20	$40	$720

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. Vermont Distribution

Emily Jones — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	301	960	90	$70	$10.6K
G0439	10	240	50	$120	$8.3K
99215	160	410	40	$110	$7.2K
99213	307	910	80	$50	$6.7K
G0402	7	20	10	$140	$2K
G0180	33	60	20	$40	$790

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Community/Behavioral Health Agency	$0	$99.3M
Washington County Family Center	VT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Treatment Associates, Inc	VT	Mental Health Counselor	$0	$6.2M
Central Vermont Medical Center Inc	VT	Family Medicine Physician	$0	$4.1M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$202.1K	$2.8M
Benjamin Newman	VT	Clinical Social Worker	$0	$1.5M
Central Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$907.7K
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$678.6K
M Gould	VT	Psychologist	$0	$574.9K
City Of Montpelier Ambulance	VT	Land Ambulance	$190.7K	$378.7K

Emily Jones — Billing Profile & Reimbursement Data

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Emily Jones — 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