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

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

John Smith (NPI 1578753869)

Field	Value
Entity Type	Individual
Organization	John Smith
Address	5825 Airline Hwy
City	Baton Rouge
State	LA
ZIP	70805
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	August 1, 2007

Payer Source	Total Paid
Medicare	$503.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
78492	In this diagnostic procedure, the provider performs a myocardial perfusion PET imaging study which means it reveals the flow of oxygenated blood to the heart muscles. The service also includes…	130	$1,110	$141.2K
A9555	Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries	130	$620	$79.5K
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…	880	$80	$71.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	620	$100	$59.4K
J2785	Injection, regadenoson, 0.1 mg	570	$40	$24.6K
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…	290	$60	$17.8K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	60	$240	$12.9K
99204	The provider sees a new 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 provider…	90	$120	$10.8K
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…	70	$130	$9.8K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	80	$130	$9.7K

Showing 1–10 of 37

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 37 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Louisiana Distribution

John Smith — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. state median

37 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
78492	22	50	100	$1,080	$123.4K
A9555	32	60	130	$540	$75.1K
93306	24	390	200	$90	$22.2K
99214	237	6,670	110	$80	$16.5K
J2785	37	150	220	$40	$16K
78452	78	250	50	$190	$13.7K
99232	480	2,580	90	$60	$13.3K
99233	962	2,010	70	$90	$12.3K
93458	48	190	30	$280	$11.7K
99213	1,391	6,060	70	$50	$8.1K

Showing 1–10 of 37

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tyler Family Circle Of Care	TX	Federally Qualified Health Center (FQHC)	$0	$48.3M
Mother Frances Hospital Regional Health Care Center	TX	General Acute Care Hospital	$0	$32.9M
Christus Health Central Louisiana	LA	General Acute Care Hospital	$0	$30.1M
Christus Trinity Clinic Texas	TX	Family Medicine Physician	$0	$22.2M
Christus Health Ark-la-tex	TX	General Acute Care Hospital	$0	$15.6M
Savoy Medical Management Group, Inc.	LA	Rural Health Clinic/Center	$0	$6.4M
Christus Health Central Louisiana	LA	Critical Access Hospital Clinic/Center	$0	$6.2M
Christus Health Central Louisiana	LA	Critical Access Hospital	$0	$4.9M
Stephen Price	LA	Physician Assistant	$3.4M	$0
Natalie Alphonse Sullivan	LA	Radiation Oncology Physician	$1.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Acadia Health LLC	LA	General Practice Dentistry	$0	$11.6M
Assisted Hands	LA	Community Health Worker	$0	$6.9M
Capital Area Human Services District	LA	Substance Abuse Rehabilitation Facility	$0	$6M
Heavenly Haven	LA	Home Health Agency	$0	$5M
Clyde Patroni	LA	Emergency Medicine Physician	$147.9K	$0
Jason Mook	LA	Emergency Medicine Physician	$125.2K	$0
Howard Wascom	LA	Certified Registered Nurse Anesthetist	$7.4K	$0

John Smith — Billing Profile & Reimbursement Data

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John Smith — 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