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

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

John Croker (NPI 1518927763)

Field	Value
Entity Type	Individual
Organization	John Croker
Address	135 E Minnesota Ave
City	Orange City
State	FL
ZIP	32763
Taxonomy	Family Nurse Practitioner
NPI Enumerated	March 23, 2006

Payer Source	Total Paid
Medicare	$6M
Medicaid	$0

Key Findings

Medicare revenue is highly concentrated: the provider reports $6M in total Medicare revenue and the precomputed top 3 Medicare codes by revenue account for 97.6% of that total. Two add-on skin/amnion product codes — Q4253 ($3.4M, 56.4%) and Q4262 ($2.4M, 40.6%) — together comprise the vast majority of billing, with the next contributor 99490 at $33.8K (0.6%).

The code mix indicates a focused advanced wound-care and skin-substitute practice rather than broad primary care billing. Q4253 and Q4262 are amniotic/dual-layer membrane products typically used in wound/graft procedures, and additional skin-substitute and debridement codes (for example 15271, 15272, 11043) appear on the file, reinforcing a procedural, wound-management service line orientation.

This provider is effectively single-payer from an operational perspective: Medicare accounts for $6M in lifetime revenue while there is no Medicaid billing on file (none below). That asymmetric payer mix means performance and reimbursement changes in Medicare will materially affect the provider’s revenue profile because Medicaid participation or revenue is absent in the dataset.

Competitive standing on the dominant product lines is above median but not overwhelmingly dominant. Q4253 ranks #14 of 73 providers nationally (82th percentile) and is characterized in the data as typical, unremarkable volume for this code; Q4262 ranks #43 of 141 (70th percentile) and is likewise labeled typical, unremarkable volume, indicating the provider is a meaningful national participant on these codes but not an extreme outlier.

Operational footprint includes a measurable home-visit and chronic care management component despite their small share of revenue. Home/residence visit codes such as 99348 (689 claims, $28.2K revenue) are present and 99348 is flagged as notably above typical national volume (97th percentile), while chronic care management codes 99490 and 99439 together appear across many monthly encounters, suggesting the practice pairs wound procedures with care coordination services.

Tenure supports an established practice presence: the NPI was enumerated 2006-03-23 (~20 years ago). Long enumeration is consistent with a sustained specialty operation that has accumulated the multi-year procedural volume reflected in high-value skin-substitute codes.

Several secondary codes show routine volumes consistent with a specialty outpatient/wound-care provider rather than a full-spectrum clinic. Codes for debridement (11043, 11046) and additional skin-substitute increments (15272) appear but contribute modest dollar amounts relative to the two dominant add-on products, suggesting a concentrated specialty service line with ancillary procedural activity.

From a business risk/opportunity standpoint, reliance on two high-revenue add-on product codes creates both vulnerability and strategic clarity. If payer coverage or utilization of Q4253 and Q4262 changes, revenue could be materially affected, while the existing presence of chronic care management (99490) and above-typical home-visit activity (99348) represent potential lever points to diversify revenue within the current clinical focus.

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q4253	Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)	4,400	$760	$3.4M
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	2,220	$1,090	$2.4M
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	830	$40	$33.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	390	$70	$28.7K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	690	$40	$28.2K
15271	The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2.	210	$100	$21.6K
11043	The provider uses surgical instruments to remove the dead tissue in muscle and/or fascia, including any debridement of the epidermis, dermis, and subcutaneous tissue, for the first or only 20 cm2 or…	120	$150	$18.1K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	440	$30	$13.5K
G0181	Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and…	140	$60	$8.4K
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…	70	$70	$5K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

John Croker — 1 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	8	40	1,120	$1,000	$1.7M
Q4253	3	20	1,070	$720	$1.3M
11043	190	310	200	$160	$60.7K
99350	523	750	80	$120	$33K
99349	407	1,570	140	$90	$27.4K
99214	21,564	32,760	140	$90	$25K
99490	173	1,200	150	$50	$19.7K
11046	107	130	120	$50	$14K
99491	90	130	70	$60	$12.4K
99213	26,119	30,010	80	$60	$12K

Showing 1–10 of 19

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Traci Zimmer	FL	Primary Care Nurse Practitioner	$251.2K	$0

Nearby Providers

Other providers in the same ZIP code as John Croker, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Neil Sandhu	FL	Dermatology Physician	$18.3M	$0
Southwest Volusia Healthcare Corporation	FL	General Acute Care Hospital	$0	$17.2M
Douglas Lieb	FL	Ophthalmology Physician	$2.7M	$0
Ratan Ahuja	FL	Cardiovascular Disease Physician	$1M	$0
Rene Cabeza	FL	Hematology & Oncology Physician	$957.1K	$0
Orange City Surgery Center LLC	FL	Ambulatory Surgical Clinic/Center	$716.9K	$204K
Cypress Ambulatory Surgery Center, LLC	FL	Ambulatory Surgical Clinic/Center	$529.6K	$41.1K
Godson Oguchi	FL	Infectious Disease Physician	$497.3K	$0
Jordan Fabrikant	FL	MOHS-Micrographic Surgery Physician	$418.2K	$0
Syed Khurshid	FL	Internal Medicine Physician	$378.5K	$0

John Croker — Billing Profile & Reimbursement Data

Sign up for John Croker — Billing Profile & Reimbursement Data policy alerts

John Croker — Billing Profile & Reimbursement Data

Sign up for John Croker — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References