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.

Carol Price (NPI 1538561618)

Field	Value
Entity Type	Individual
Organization	Carol Price
Address	104 Hardin Ln
City	Somerset
State	KY
ZIP	42503
Taxonomy	Psychiatric/Mental Health Nurse Practitioner
NPI Enumerated	September 21, 2014

Payer Source	Total Paid
Medicare	$53.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	390	$60	$24.4K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	520	$40	$21.2K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	40	$110	$4.2K
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	$60	$3.9K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Carol Price — 1 of 4 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

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	137	470	170	$70	$24.3K
99214	4,568	7,230	110	$70	$14.1K
99306	82	150	50	$130	$9.3K
90833	4	140	60	$40	$4.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lake Cumberland Surgery Center LP	KY	Ambulatory Surgical Clinic/Center	$1M	$8.7M
N Mullai	KY	Hematology & Oncology Physician	$840.6K	$0
Melissa Cheng	KY	Nurse Practitioner	$703.4K	$0
Michelle King	KY	Family Nurse Practitioner	$230.2K	$0
Amr El-naggar	KY	Neurological Surgery Physician	$227.7K	$0
Kenneth Ruby	KY	Urology Physician	$193.1K	$0
Daniel Yanicko	KY	Orthopaedic Surgery Physician	$117.5K	$0
Shawn Acino	KY	Urology Physician	$103.2K	$0
Todd Horn	KY	Gastroenterology Physician	$97K	$0
Charles Hatmaker	KY	Surgical Physician Assistant	$81.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Morrland Healthcare LLC	KY	Community/Behavioral Health Agency	$0	$54.8M
Applied Behavioral Advancements, LLC	KY	Community/Behavioral Health Agency	$0	$29.2M
Protea Behavioral Health Counseling, PLLC	KY	Professional Counselor	$0	$24.4M
Lake Cumberland Regional Hospital, LLC	KY	Internal Medicine Physician	$0	$15.6M
Cumberland Behavior Group, LLC	KY	Community/Behavioral Health Agency	$0	$15.2M
Quest Counseling	KY	Mental Health Counselor	$0	$12.5M
Lake Cumberland Recovery, Inc	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Achievements Through Actions	KY	Developmentally Disabled Services Day Training Agency	$0	$10M
Adult Day Health, Inc.	KY	Adult Day Care Clinic/Center	$0	$8.9M
Infinite Abilities & Supports, Inc.	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.9M

Carol Price — Billing Profile & Reimbursement Data

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Carol Price — 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

Nearby Providers

Frequently Asked Questions

References