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

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

Klaus Mergener (NPI 1578537031)

Field	Value
Entity Type	Individual
Organization	Klaus Mergener
Address	21600 Highway 99 Ste 260
City	Edmonds
State	WA
ZIP	98026
Taxonomy	Gastroenterology Physician
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicare	$28.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	100	$100	$9.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	$130	$4.7K
43264	The provider performs a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of dye, into the biliary ducts to obtain fluoroscopic images…	20	$260	$4.6K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	40	$80	$2.9K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	20	$130	$2.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	$60	$1.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	20	$70	$1.5K
74328	In this procedure, the provider performs imaging supervision and interpretation, S&I, for a separately reportable endoscopic biliary duct catheterization. The provider X–rays the biliary ducts during…	30	$20	$580
43262	The provider performs an endoscopic retrograde cholangiopancreatography (ERCP), a diagnostic procedure that combines upper endoscopy and retrograde (reverse) injection of contrast material, a type of…	20	$30	$440

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Klaus Mergener — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
43239	317	370	60	$120	$9.3K
99232	2,325	3,100	70	$60	$7.5K
99223	1,028	2,570	30	$130	$6.4K
45378	47	130	20	$200	$4.2K
43264	29	40	30	$90	$3.6K
99222	60	1,690	20	$100	$3K
43235	21	180	20	$120	$2.9K
74328	14	30	30	$20	$780
43262	5	20	20	$40	$720

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington Gastroenterology PLLC	WA	Gastroenterology Physician	$0	$5.1M
Puget Sound Gastroenterology, PLLC	WA	Ambulatory Surgical Clinic/Center	$756.5K	$0
Puget Sound Gastroenterology, PLLC	WA	Ambulatory Surgical Clinic/Center	$497.1K	$2.4K
John Carpenter	WA	Anatomic Pathology & Clinical Pathology Physician	$485.9K	$0
Michelle Hendrickx	WA	Family Nurse Practitioner	$481.1K	$0
Nasla Loya	WA	Family Nurse Practitioner	$435.5K	$0
Sharon Barker	WA	Physician Assistant	$434.5K	$0
Puget Sound Gastroenterology, PLLC	WA	Ambulatory Surgical Clinic/Center	$347.6K	$67.5K
Mark Lyda	WA	Anatomic Pathology & Clinical Pathology Physician	$400.7K	$0
John Scarborough	WA	Anatomic Pathology & Clinical Pathology Physician	$351.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Swedish Edmonds	WA	General Acute Care Hospital	$0	$30.1M
Convalescent Equipment & Supply Co. Inc.	WA	Durable Medical Equipment & Medical Supplies	$0	$7.7M
Cep America LLC	WA	Emergency Medicine Physician	$0	$5.5M
Laurie Jacobson	WA	MOHS-Micrographic Surgery Physician	$586.3K	$0
Arpenik Avakian	WA	Ophthalmology Physician	$499.5K	$0
Optum Care Washington PLLC	WA	Ambulatory Surgical Clinic/Center	$288.5K	$0
Andrew Davis	WA	Ophthalmology Physician	$285.5K	$0
Proliance Surgeons Inc P S	WA	Ambulatory Surgical Clinic/Center	$275.9K	$0
Anne Pesenson	WA	Nephrology Physician	$180.8K	$0
Gandis Mazeika	WA	Sleep Medicine (Psychiatry & Neurology) Physician	$178.2K	$50

Klaus Mergener — 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