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

Why is the Medicaid comparison limited to Mississippi 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. Mississippi (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 M. Headley, M.d. PA (NPI 1578627782)

David M. Headley, M.d. PA is a family medicine physician provider located in Port Gibson, Mississippi. This profile covers 0 Medicare and 53 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	David M. Headley, M.d. PA
Address	405 Market St
City	Port Gibson
State	MS
ZIP	39150
Taxonomy	Family Medicine Physician
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

53 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…	55,610	$50	$2.7M
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	26,710	$10	$267.1K
J1040	Injection, methylprednisolone acetate, 80 mg	10,500	$10	$73.5K
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…	1,490	$50	$68.4K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	4,330	$10	$51.9K
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…	4,470	$10	$35.7K
99203	The provider sees a new 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 provider…	450	$70	$33.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	1,320	$20	$27.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	870	$30	$26.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	480	$20	$11.5K

Showing 1–10 of 53

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

David M. Headley, M.d. PA — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	20	1,910	930	$60	$278.7K
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…	59	280	680	$20	$102K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	195	670	230	$60	$89.5K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	22	170	600	$20	$58.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	13	750	400	$20	$52.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	75	160	300	$40	$41.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	334	620	570	$10	$38K
99203	The provider sees a new 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 provider…	173	680	100	$50	$34.8K
99219	N/A	13	30	70	$70	$25.9K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	17	70	210	$30	$25.3K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
At Home Care, Inc.	MS	Home Health Agency	$0	$58M
Claiborne County Hospital	MS	Critical Access Hospital	$0	$9.3M
At Home Care, Inc	MS	Nursing Care Agency	$0	$6M
Renex Dialysis Facilities, Inc.	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.4M
Claiborne County Family Health Center	MS	Federally Qualified Health Center (FQHC)	$0	$1.3M
Kendrique Morgan	MS	Physical Therapist	$34.9K	$0

David M. Headley, M.d. PA — Billing Profile & Reimbursement Data

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David M. Headley, M.d. PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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