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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

David Daniels (NPI 1538394952)

Field	Value
Entity Type	Individual
Organization	David Daniels
Address	455 N Sioux Point Rd
City	Dakota Dunes
State	SD
ZIP	57049
Taxonomy	Urology Physician
NPI Enumerated	May 29, 2009

Payer Source	Total Paid
Medicare	$307.9K
Medicaid	$0

Key Findings

This provider’s billings are effectively single‑payer: total Medicare revenue is $307.9K and there is no Medicaid billing on file, so DAVID DANIELS operates with Medicare as the dominant (and only reported) public payer in this dataset. The absence of Medicaid activity suggests either non‑participation in Medicaid or a patient panel that does not include Medicaid beneficiaries, which will shape payer mix and network negotiation considerations in‑state.

Revenue is highly concentrated in a small number of services: the top 3 Medicare codes by revenue account for 63.7% of total Medicare revenue, with J0897 contributing $109.5K (35.8% of Medicare revenue), 99214 contributing $61.1K (20.0%), and J9217 contributing $24.5K (8.0%). This concentration means changes in utilization, reimbursement, or formulary coverage for these specific products or visit types could materially affect the practice’s revenue.

Code mix and descriptions indicate a urology practice with a strong office‑based medical oncology component. High revenue from J0897 (denosumab) and J9217 (leuprolide acetate) alongside substantial E/M billing for 99214 and 99204 suggests the provider manages prostate cancer patients in the office setting with in‑office injections and frequent follow‑up visits, rather than relying solely on surgical volume.

99214 is a standout for outpatient visit volume: 686 claims produced $61.1K (20.0% of Medicare revenue) and the code ranks in the 94th percentile nationally with the label "notably above typical national volume for this code," indicating this provider is well above peers in established‑patient office visits. By contrast, J0897 (rank #2417 of 10057, 76th percentile) and J9217 (rank #984 of 3683, 73th percentile) are described as "typical, unremarkable volume for this code," so the provider’s competitive edge appears strongest in evaluation-and-management activity rather than in unusually high national dominance for injections.

The procedural portfolio remains clinically active but not dominant: 52000 (cystourethroscopy) accounts for $15.9K (5.2% of Medicare revenue) with 153 claims and ranks in the 85th percentile (typical, unremarkable volume), while 52601 (TURP) contributes $11K (3.6% of revenue) over 21 claims and also ranks as typical. These entries indicate routine endoscopic and surgical urology services are a steady but secondary revenue stream relative to injections and office visits.

Operational profile is consistent with high‑throughput, office‑based diagnostics and injections: 51798 (post‑void residual ultrasound) has 499 claims, $4K revenue and ranks in the 91th percentile (typical, unremarkable volume), and 36415 (venipuncture) has 282 claims and $2.3K revenue (78th percentile). The combination of frequent low‑unit payments (e.g., $19 avg for J0897, $8 avg for 51798) with high claim counts suggests workflows optimized for throughput of recurring in‑office services.

The NPI tenure signals an established practice presence: the provider enumerated on 2009-05-29 (~17 years ago), which supports the interpretation that observed billing patterns reflect an ongoing care model rather than a short‑term or newly launched service line. Given this longevity and the revenue mix, payer negotiations or service expansions should account for a stable, Medicare‑focused patient base.

Medicare: Complete Services Breakdown

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	5,760	$20	$109.5K
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…	690	$90	$61.1K
J9217	Leuprolide acetate (for depot suspension), 7.5 mg	180	$140	$24.5K
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…	170	$120	$20.7K
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…	280	$60	$17K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	150	$100	$15.9K
52601	During transurethral resection of the prostate (TURP), the surgeon inserts a resectoscope via the urethra and removes a portion of the prostate. This procedure includes several other urological…	20	$530	$11K
51729	In this procedure, the provider performs a complex cystometrogram along with voiding pressure studies and urethral pressure profile studies to diagnose certain urinary disorders like an overactive…	20	$300	$5.1K
52356	The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…	20	$290	$4.3K
84153	The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and…	240	$20	$4.3K

Showing 1–10 of 36

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 36 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

David Daniels — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

36 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	4	40	2,460	$20	$52.8K
J9217	7	20	160	$130	$21.6K
52287	8	10	30	$200	$20K
52000	8	30	130	$100	$15.3K
55700	15	20	30	$260	$14.4K
99214	53	1,660	90	$70	$11.4K
52601	1	10	20	$530	$8.4K
99215	342	450	40	$100	$7.5K
52356	11	10	20	$310	$7K
99213	184	1,710	80	$50	$6.4K

Showing 1–10 of 36

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
NPI 1588636484	—	—	$3.2M	$0
Ryan Geraets	SD	Ophthalmology Physician	$3M	$0
John Bormes	SD	Ophthalmology Physician	$2.6M	$0
Pender Community Hospital District	NE	Rural Health Clinic/Center	$0	$2.4M
Elizabeth Atchison	SD	Ophthalmology Physician	$1.7M	$0
Ashar Luqman	IA	Nephrology Physician	$1.4M	$0
Taylor Slingsby	SD	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Ty Hanson	SD	Dermatology Physician	$1.2M	$0
Alexander Ringeisen	MN	Retina Specialist (Ophthalmology) Physician	$1.1M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cnos PC	SD	Orthopaedic Surgery Physician	$0	$3.6M
Dunes Dental 4 Kids, LLP	SD	Pediatric Dentistry	$0	$3.3M
Liem Som Oei Md PC	SD	Nephrology Physician	$0	$2.4M
Ear Nose And Throat Consultants And Hearing Services Plc	SD	Otolaryngology Physician	$0	$2.2M
Oral Surgery Assocates, P.C.	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$2.1M
Dunes Anesthesia PC	SD	Pain Medicine (Anesthesiology) Physician	$0	$1.1M
Midlands Clinic, P.C.	SD	Specialist	$0	$822.9K
Dunes Medical Laboratories	SD	Clinical Medical Laboratory	$303K	$416.6K
Beth Bruening	SD	Ophthalmology Physician	$704.9K	$2.2K
Neal Khurana	SD	Vascular & Interventional Radiology Physician	$704.3K	$0

David Daniels — Billing Profile & Reimbursement Data

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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