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

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

Mallory Baker (NPI 1518209089)

Field	Value
Entity Type	Individual
Organization	Mallory Baker
Address	550 S Jackson St
City	Louisville
State	KY
ZIP	40202
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 22, 2013

Payer Source	Total Paid
Medicare	$51.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	300	$70	$21.2K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	150	$120	$17.5K
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…	90	$60	$4.8K
G0444	Annual depression screening, 5 to 15 minutes	150	$20	$2.5K
G0442	Annual alcohol misuse screening, 5 to 15 minutes	130	$20	$2.3K
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…	20	$60	$1.1K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	30	$30	$960
G0008	Administration of influenza virus vaccine	30	$20	$770
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	30	$10	$210
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	20	$1	$40

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 10 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Mallory Baker — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

10 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,452	7,230	110	$70	$14.1K
G0439	268	1,570	60	$110	$9.3K
99213	3,472	7,250	80	$50	$7.7K
99204	2,370	3,200	30	$100	$4.8K
G0008	1,187	1,910	50	$30	$2K
36415	858	1,040	100	$10	$1.7K
G0444	45	290	50	$20	$1.2K
90674	15	70	20	$30	$1K
G0442	8	90	50	$10	$950
81003	898	1,240	30	$1	$150

Mallory Baker — 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