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.

Matthew Marsh (NPI 1508290941)

Key Findings

Field	Value
Entity Type	Individual
Organization	Matthew Marsh
Address	7070 E Dr N
City	Battle Creek
State	MI
ZIP	49014
Taxonomy	Medical Physician Assistant
NPI Enumerated	August 21, 2013

Payer Source	Total Paid
Medicare	$118.1K
Medicaid	$0

MATTHEW MARSH’s Medicare billing profile is dominated by outpatient E/M visits and dermatologic procedures: the top three revenue codes are 99213 ($48.8K, 41.3% of Medicare revenue), 11102 ($12.9K, 10.9%), and 12032 ($12.3K, 10.4%). These codes and their descriptions indicate a practice focused on established office visits combined with skin lesion biopsies and intermediate wound/repair work, consistent with a Medical Physician Assistant operating in a dermatology- or minor-procedures–oriented ambulatory setting.

Revenue concentration is high: the provider’s total Medicare revenue is $118.1K and the precomputed top-3 codes account for 62.7% of that Medicare revenue. That level of concentration around a single E/M code plus two procedure codes suggests business risk tied to a small set of visit types and procedures rather than a broadly diversified CPT mix.

The payer mix is effectively single-payer in this data set: Medicare revenue is $118.1K and there is no Medicaid billing on file. The absence of Medicaid activity means the provider’s publicly observable reimbursement and utilization are driven entirely by Medicare, which could reflect patient panel composition, payer contracting choices, or practice site eligibility.

On competitive standing for office visits, the provider is a clear national outlier for 99213: 996 claims, $49 avg paid/claim, ranking #6504 of 457151 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). This indicates materially higher-than-typical volume of low-level established patient visits compared with peers nationally and is the single largest driver of Medicare dollars for this clinician.

For dermatologic procedures, the provider shows solid but not dominant participation: 11102 (230 claims, $56 avg paid/claim) ranks #4709 of 18797 providers nationally (75th percentile; typical, unremarkable volume for this code), and 12032 (70 claims, $176 avg paid/claim) ranks #1112 of 6420 providers nationally (82th percentile; typical, unremarkable volume for this code). These percentiles indicate the provider performs a meaningful number of biopsies and intermediate repairs, but is not a national leader in these procedures the way they are for 99213.

Procedure mix also includes a high count of low-paid add-on lesion treatments: 17003 appears 865 times with $4 avg paid/claim for $3.5K in revenue (2.9% of Medicare revenue), and 17000 appears 371 times with $32 avg paid/claim for $11.9K (10.1% of Medicare revenue). The combination of many low-unit, low-paid lesion destructions alongside higher-volume E/M work suggests a practice workflow that integrates brief procedural treatments into office visits rather than concentrating on high-revenue surgical cases.

Tenure in the public record is established: NPI enumerated on 2013-08-21 (~13 years ago), indicating a long-enough presence to have built a stable Medicare billing pattern. Given the modest lifetime Medicare revenue of $118.1K and high concentration in a few CPTs, this profile is consistent with a mid-sized or clinic-embedded PA practice rather than a high-revenue independent surgical practice.

Operational and strategic implications from a payer or competitor viewpoint: the provider’s absence of Medicaid billing presents a gap in public-payer exposure and may affect network negotiations or access for Medicaid patients in the local market. Combined with an extreme national outlier status for 99213 volume, payers and competing providers should view this clinician as a high-volume Medicare office-visit resource with procedural capacity for biopsies and wound repairs but limited observable Medicaid footprint.

Medicare: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,000	$50	$48.8K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	230	$60	$12.9K
12032	This CPT® code is used for the intermediate repair of wounds to the scalp, axillae, trunk and/or extremities (excluding hands and feet) that are 2.6 to 7.5 cm in size.	70	$180	$12.3K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	370	$30	$11.9K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	100	$70	$6.4K
11602	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the trunk, arms, or legs.	60	$80	$4.7K
99203	The provider sees a new 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 provider…	70	$60	$3.9K
17003	In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through…	870	$1	$3.5K
11103	The provider biopsies an additional skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. Report +11103 for each separate lesion…	100	$30	$3K
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,…	90	$30	$2.9K

Showing 1–10 of 16

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	83	15,470	80	$80	$11.4K
17110	2	660	80	$70	$8.6K
11102	1	500	90	$60	$7.1K
17004	2	190	30	$120	$7K
17000	2	580	130	$40	$6.9K
12032	1	170	30	$190	$6.8K
99213	2	14,810	60	$60	$6.6K
17003	2	520	440	$1	$3.1K
12031	1	20	10	$160	$3K
99203	4	4,560	30	$70	$3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Donn Latour	MI	MOHS-Micrographic Surgery Physician	$699.2K	$14.4K
Roger Moore	IN	Dermatology Physician	$693.9K	$0
Travis Morrell	CO	Dermatology Physician	$255.8K	$0
Esther Latour	MI	Specialist	$228K	$0
Katrina Hadcock	MI	Family Nurse Practitioner	$141K	$0
Jared Wilson	MI	Physician Assistant	$117.3K	$0
John Pomann	MI	Dermatology Physician	$112.8K	$0
Stephanie Mason	MI	Physician Assistant	$107.9K	$0
Jared Wilson	AR	Physician Assistant	$104.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Victory Clinical Services Battle Creek LLC	MI	Multi-Specialty Clinic/Center	$73.7K	$6.7M
Timothy Spencer	MI	Neurological Surgery Physician	$288.6K	$0
Younho Chung	MI	Internal Medicine Physician	$228.5K	$0
Jeromy Myers	MI	Chiropractor	$60.1K	$0

Matthew Marsh — Billing Profile & Reimbursement Data

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Matthew Marsh — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

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