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

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

Justin Roe (NPI 1538393079)

Field	Value
Entity Type	Individual
Organization	Justin Roe
Address	701 E Marshall St
City	West Chester
State	PA
ZIP	19380
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 12, 2009

Payer Source	Total Paid
Medicare	$153.7K
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.	530	$140	$75.8K
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…	250	$180	$43K
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.	300	$100	$29.4K
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.	40	$60	$2.2K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	430	$10	$2.1K
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	$50	$690

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. Pennsylvania Distribution

Justin Roe — 4 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	63	3,230	120	$140	$20.3K
99291	144	3,800	40	$170	$11.7K
99284	22	3,350	60	$90	$6.9K
99283	240	1,570	20	$50	$1.4K
12002	4	10	10	$60	$800
93042	2	190	60	$10	$540

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Ader	PA	Emergency Medicine Physician	$170.7K	$0
Christopher Ware	PA	Emergency Medicine Physician	$150.4K	$0
Michael Mihalakis	PA	Emergency Medicine Physician	$142.2K	$0
Rosamund Lehmann	PA	Emergency Medicine Physician	$132K	$0
Davis Clark	PA	Emergency Medicine Physician	$113.3K	$0
Michele Kossey	PA	Emergency Medicine Physician	$112.6K	$610

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Theraplay, LLC	PA	Occupational Therapist	$0	$38.5M
The Devereux Foundation	PA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$29.7M
County Of Chester	PA	Case Management Agency	$0	$19.5M
Chester County Hospital	PA	General Acute Care Hospital	$410	$10.2M
Bruce Saran	PA	Ophthalmology Physician	$2.9M	$0
Michael Ward	PA	Ophthalmology Physician	$2.7M	$0
Muve - West Chester Ambulatory Surgical Center, LLC	PA	Ambulatory Surgical Clinic/Center	$2.4M	$0
Michael Rosen	PA	Internal Medicine Physician	$1.5M	$0
West Chester Endoscopy LLC	PA	Endoscopy Clinic/Center	$1.3M	$0
Good Fellowship Club Of Chester County, Inc.	PA	Land Ambulance	$591.2K	$585K

Justin Roe — Billing Profile & Reimbursement Data

Sign up for Justin Roe — Billing Profile & Reimbursement Data policy alerts

Justin Roe — Billing Profile & Reimbursement Data

Sign up for Justin Roe — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References