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

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

Micah Mcdonald (NPI 1558658062)

Field	Value
Entity Type	Individual
Organization	Micah Mcdonald
Address	1001 Sam Perry Blvd
City	Fredericksburg
State	VA
ZIP	22401
Taxonomy	Physician Assistant
NPI Enumerated	July 5, 2011

Payer Source	Total Paid
Medicare	$7.6K
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
33533	Coronary artery bypass, using arterial graft(s); single arterial graft	40	$180	$6.4K
33519	The provider diverts blood flow from damaged vessels in the heart by grafting three vein segments taken from another location, such as the leg, while the patient is undergoing a coronary artery…	10	$60	$670
33518	The provider diverts blood flow from damaged vessels in the heart by grafting two vein segments taken from another location, such as the leg, while the patient is undergoing a coronary artery bypass…	10	$40	$500
33508	The provider employs surgical endoscopy to visualize structures surrounding the vein he harvests for a coronary artery bypass procedure.	40	$1	$70

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. Virginia Distribution

Micah Mcdonald — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33533	13	80	20	$950	$22.7K
33519	7	10	10	$370	$4.8K
33518	28	50	10	$240	$3.5K
33508	12	80	20	$10	$210

Micah Mcdonald — Billing Profile & Reimbursement Data

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Micah Mcdonald — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References