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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Daniel Kwan (NPI 1518114859)

Field	Value
Entity Type	Individual
Organization	Daniel Kwan
Address	235 Plain St
City	Providence
State	RI
ZIP	02905
Taxonomy	Plastic Surgery Physician
NPI Enumerated	August 19, 2008

Payer Source	Total Paid
Medicare	$94.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 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.	90	$910	$78.7K
13102	This is for a complex repair of each additional 5 cm or less of a wound to the trunk. This CPT code is listed separately in addition to the code for the primary procedure and covers additional…	170	$60	$9.5K
13101	This is for a complex repair of a wound to the trunk. This wound should be 2.6 to 7.5 cm in size.	50	$110	$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	$70	$830

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Rhode Island Distribution

Daniel Kwan — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
15734	1	10	60	$700	$41.2K
13102	1	10	170	$60	$9.5K
99213	1,895	1,950	70	$60	$7.4K
13101	1	10	20	$210	$5.8K

Daniel Kwan — Billing Profile & Reimbursement Data

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Daniel Kwan — 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