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

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

David Baker (NPI 1487809992)

Field	Value
Entity Type	Individual
Organization	David Baker
Address	1267 Mount Olive Rd
City	Lookout Mountain
State	GA
ZIP	30750
Taxonomy	Professional Counselor
NPI Enumerated	November 25, 2008

Payer Source	Total Paid
Medicaid	$403.7K
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,010	$90	$174.9K
H2015	Comprehensive community support services, per 15 minutes	1,270	$70	$88.8K
H0031	Mental health assessment, by non-physician	260	$140	$37.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	380	$70	$25.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	410	$40	$15.1K
H2017	Psychosocial rehabilitation services, per 15 minutes	180	$80	$14.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	120	$90	$10.6K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	120	$70	$7.6K
H0032	Mental health service plan development by non-physician	140	$50	$7.3K
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…	50	$120	$6K

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Georgia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Georgia Distribution

David Baker — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1003	Lpn/lvn services, up to 15 minutes	17	20	470	$150	$1.1M
H2017	Psychosocial rehabilitation services, per 15 minutes	18	20	3,800	$70	$896.7K
H2015	Comprehensive community support services, per 15 minutes	24	40	2,260	$70	$518.1K
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…	745	920	370	$60	$360.6K
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…	636	820	390	$70	$245K
H0031	Mental health assessment, by non-physician	31	80	80	$110	$233.6K
H2014	Skills training and development, per 15 minutes	28	30	620	$50	$166.3K
T1002	Rn services, up to 15 minutes	26	30	640	$50	$162.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	241	360	370	$50	$153.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	172	880	410	$90	$148.7K

Showing 1–10 of 16

David Baker — Billing Profile & Reimbursement Data

Sign up for David Baker — Billing Profile & Reimbursement Data policy alerts

David Baker — Billing Profile & Reimbursement Data

Sign up for David Baker — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References