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

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

Philip Smith (NPI 1508966581)

Field	Value
Entity Type	Individual
Organization	Philip Smith
Address	1100 Goethals Drive 2nd Floor
City	Richland
State	WA
ZIP	99352
Taxonomy	Surgery Physician
NPI Enumerated	September 22, 2006

Payer Source	Total Paid
Medicare	$50.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
15734	The provider develops a muscle, myocutaneous, or fasciocutaneous flap obtained from the trunk (the area between the neck and the waist) and places it over a defect on the patient's body.	20	$940	$22.6K
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	10	$490	$6.8K
49650	The provider performs laparoscopic repair of an initial inguinal hernia.	20	$360	$6.4K
99204	The provider sees a new 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 provider…	50	$90	$4.5K
49324	The provider examines the inside of the abdomen through a laparoscope, a tubular instrument with a light source and a camera. He places a catheter, a flexible tube, into the membrane lined portion of…	10	$300	$3.9K
99205	The provider sees a new 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 provider…	20	$130	$2.4K
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…	30	$60	$1.6K
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…	20	$80	$1.5K
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…	10	$50	$740

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Philip Smith — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
15734	2	10	20	$1,000	$19.9K
99214	9,852	10,860	100	$80	$13.6K
49650	24	60	20	$520	$10K
47562	9	20	10	$530	$7.9K
99213	9,168	9,690	60	$60	$6.5K
99205	1,243	1,820	30	$150	$5.4K
99204	1,449	4,750	30	$110	$5.2K
49324	2	10	10	$300	$4.1K
99203	1,654	3,140	30	$70	$3.3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kadlec Regional Medical Center	WA	General Acute Care Hospital	$0	$151.5M
Guy Jones	NV	Radiation Oncology Physician	$2.5M	$0
Kadlec Regional Medical Center	WA	Ambulatory Surgical Clinic/Center	$571.3K	$815.5K
Sherry Zhao	WA	Radiation Oncology Physician	$1.3M	$0
Kadlec Regional Medical Center	WA	Ambulatory Surgical Clinic/Center	$231.7K	$158.7K
Glen Zuroske	WA	Cardiovascular Disease Physician	$372.5K	$0
Fareed Arif	WA	Nephrology Physician	$369.2K	$0
Melvin Wahl	WA	Orthopaedic Surgery of the Spine Physician	$327.4K	$0
Sarena Sloot	WA	Nurse Practitioner	$307.9K	$0
Joshua Bales	WA	Orthopaedic Surgery Physician	$304.9K	$0

Philip Smith — Billing Profile & Reimbursement Data

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Philip Smith — 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

Frequently Asked Questions

References