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

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

Wayne Jones (NPI 1518953900)

Field	Value
Entity Type	Individual
Organization	Wayne Jones
Address	25442 Al Highway 127
City	Elkmont
State	AL
ZIP	35620
Taxonomy	Emergency Medicine Physician
NPI Enumerated	September 21, 2005

Payer Source	Total Paid
Medicare	$105.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	570	$120	$68.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	290	$80	$24K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	60	$150	$8.1K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	80	$50	$3.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	220	$10	$1.3K
12002	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.6 to 7.5 cm in…	10	$40	$420

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Alabama Distribution

Wayne Jones — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	5	830	90	$130	$16.9K
99291	335	910	40	$160	$10.6K
99284	3	870	60	$80	$6.2K
93010	198	760	90	$10	$1.6K
99283	21	400	20	$50	$1.4K
12002	4	10	20	$40	$600

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Athens-limestone Er Physicians	AL	Emergency Medicine Physician	$0	$1.7M
Emergency Medical Associates, Inc	AL	Emergency Medicine Physician	$0	$1.4M
John Kaliszak	AL	Emergency Medicine Physician	$256.7K	$0
Daniel Burnes	AL	Family Medicine Physician	$162.1K	$0
Sharon Mbuko	AL	Internal Medicine Physician	$99.5K	$0
Brandi Ray	AL	Adult Health Nurse Practitioner	$96.5K	$0
Kenneth Collins	AL	Emergency Medicine Physician	$93.1K	$0
Robert Flowers	AL	Internal Medicine Physician	$71.7K	$0
Shoaib Sheikh	WI	Hospitalist Physician	$62.9K	$0
Jennifer Grutzik	AL	Physician Assistant	$58.4K	$0

Wayne Jones — Billing Profile & Reimbursement Data

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Wayne Jones — 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