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

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Sandra Wixson (NPI 1588870349)

NPI 1588870349 · Ulloa, XX · Psychologist

Sandra Wixson is a psychologist provider located in Ulloa, Unspecified Location. This profile covers 1 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.

NPI 1588870349 · Ulloa, XX · Psychologist

Provider details (source: NPPES NPI Registry)

Field	Value
Entity Type	Individual
Organization	Sandra Wixson
Address	Rotunda 8, Casa # 163
City	Ulloa
State	XX (Unspecified Location)
ZIP	NA
Taxonomy	Psychologist
NPI Enumerated	May 15, 2007

Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

Payer Source	Total Paid
Medicare	$27.5K
Medicaid	$0

This NPI is registered to a Psychologist whose Medicare billing is almost entirely psychotherapy by time-intensive sessions: the top billed code is 90837 (psychotherapy, 53+ minutes), with 283 claims, $97 avg paid/claim, and $27.5K in Medicare revenue. The code description and claim mix indicate the provider’s service line is focused on individual, long-format outpatient psychotherapy rather than procedure-based or ancillary behavioral health services.

Revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 100.0% of this provider's total Medicare revenue, and the single listed code 90837 represents that share in practice. This concentration shows the provider relies on a very narrow set of billable services for all reported Medicare income.

The payer mix is effectively single-payer at the claim level: total Medicare revenue is $27.5K while there is no Medicaid billing on file. The absence of Medicaid activity means the provider’s public-payer exposure is exclusively Medicare in this dataset, which concentrates reimbursement and access risk into a single federal payer stream.

On national competitive standing for the principal code, the provider ranks #4207 of 15257 nationally (72th percentile; typical, unremarkable volume for this code). That ranking and the supplied label indicate the provider is a modest, not a dominant, participant in delivering 90837 services at the national level.

The practitioner has an established enrollment history, with the NPI enumerated 2007-05-15 (~19 years ago). Long tenure in the enrollment file suggests sustained presence in the Medicare program, even though current Medicare revenue is modest in scale.

Statistically, the activity level for 90837 is characterized in the source as "typical, unremarkable volume for this code," which aligns with the mid-tier national percentile provided. There are no supplied labels or measures indicating extreme deviation or notable outlier behavior for reported Medicare psychotherapy activity.

Operationally, the combination of modest total Medicare revenue ($27.5K) and a low average payment per claim ($97) is consistent with a small-volume psychotherapy practice focused on long psychotherapy encounters. The narrow service mix and lack of Medicaid billing imply limited public-payer diversification and may constrain scale and negotiating leverage unless the provider expands service lines or payer relationships.

Medicare revenue breakdown by CPT/HCPCS procedure code.

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

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	280	$100	$27.5K

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

Full comparison — all codes billed, vs. state median

Sandra Wixson — Billing Profile & Reimbursement Data

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Sandra Wixson — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References