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

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

Paul Somerville (NPI 1598738304)

Field	Value
Entity Type	Individual
Organization	Paul Somerville
Address	5312 Lapeer Rd
City	Kimball
State	MI
ZIP	48074
Taxonomy	Family Medicine Physician
NPI Enumerated	February 10, 2006

Payer Source	Total Paid
Medicare	$66K
Medicaid	$0

Medicare: Complete Services Breakdown

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

17 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…	770	$60	$44.5K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	50	$120	$6.1K
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…	490	$10	$4.4K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	40	$70	$3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	300	$10	$1.5K
G0008	Administration of influenza virus vaccine	50	$30	$1.4K
G0444	Annual depression screening, 5 to 15 minutes	60	$20	$970
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	30	$30	$900
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…	10	$80	$850
J1040	Injection, methylprednisolone acetate, 80 mg	70	$10	$520

Showing 1–10 of 17

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Paul Somerville — 2 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

17 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	15,344	15,470	80	$80	$11.4K
99490	399	450	100	$50	$10.4K
99213	174	14,810	60	$60	$6.6K
G0439	1,837	4,100	50	$100	$6.6K
90662	767	1,920	40	$70	$3.9K
G0008	1,653	3,440	50	$30	$2.2K
36415	232	1,860	70	$10	$1.6K
G0180	467	550	20	$40	$1.3K
G0444	503	1,250	50	$20	$1.1K
93000	1,680	1,990	30	$10	$970

Showing 1–10 of 17

Paul Somerville — Billing Profile & Reimbursement Data

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Paul Somerville — 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