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

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

Simmonds, Martin & Helmbrecht, LLC (NPI 1558411934)

Simmonds, Martin & Helmbrecht, LLC is a obstetrics & gynecology physician provider located in Damascus, Maryland. This profile covers 0 Medicare and 38 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Simmonds, Martin & Helmbrecht, LLC
Address	26005 Ridge Rd
City	Damascus
State	MD
ZIP	20872
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	January 10, 2007

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

38 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	37,520	$80	$2.9M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	3,150	$840	$2.6M
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…	6,260	$110	$670.2K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	260	$970	$250.5K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	2,010	$100	$202.6K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	1,470	$110	$161.4K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,310	$120	$150.9K
H1003	Prenatal care, at-risk enhanced service; education	14,320	$10	$128.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1,440	$90	$122.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	16,180	$1	$64.7K

Showing 1–10 of 38

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maryland Distribution

Simmonds, Martin & Helmbrecht, LLC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	443	3,670	680	$90	$310K
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…	45	3,280	610	$80	$296.1K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	19	30	670	$130	$291.4K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	1	20	60	$810	$256.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	20	60	370	$70	$195.6K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	20	20	450	$60	$184.1K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	28	40	220	$60	$180.5K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	10	60	270	$90	$155.3K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	33	70	340	$80	$115.2K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	5	20	90	$350	$102.9K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhonda Stewart	NC	Diagnostic Radiology Physician	$265.7K	$61.8K
Kenneth Fox	NC	Diagnostic Radiology Physician	$303K	$360
Donna Mazloomdoost	VA	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$77.9K	$0
Diane Snyder	MD	Obstetrics & Gynecology Physician	$70K	$0
Amy Levav	MD	Obstetrics & Gynecology Physician	$51.9K	$0
Eric Chang	VA	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	$39.3K	$0
Kathleen Gotzmann	MD	Specialist	$22.1K	$0
Rebecca Busch	DC	Obstetrics & Gynecology Physician	$14.5K	$0
Mary Abraham	DC	Obstetrics & Gynecology Physician	$13K	$0
Kristin Wexler	UT	Obstetrics & Gynecology Physician	$5.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Lee	MD	Dermatology Physician	$645.9K	$0
Benjamin Papoi	MD	Family Medicine Physician	$400.1K	$0

Simmonds, Martin & Helmbrecht, LLC — Billing Profile & Reimbursement Data

Sign up for Simmonds, Martin & Helmbrecht, LLC — Billing Profile & Reimbursement Data policy alerts

Simmonds, Martin & Helmbrecht, LLC — Billing Profile & Reimbursement Data

Sign up for Simmonds, Martin & Helmbrecht, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References