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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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 Nicholas (NPI 1609898022)

Field	Value
Entity Type	Individual
Organization	Paul Nicholas
Address	24 East Ave
City	Woodstown
State	NJ
ZIP	08098
Taxonomy	Family Medicine Physician
NPI Enumerated	July 24, 2006

Payer Source	Total Paid
Medicare	$53.2K
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
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…	250	$70	$17.3K
98927	The provider performs controlled manual pressure in five to six body regions to treat somatic and nonsomatic disorders.	330	$50	$15K
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…	100	$100	$10.1K
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…	70	$60	$3.7K
20552	Trigger point injection, or TPI, is a medical procedure that involves injecting an anesthetic or corticosteroid substance to relieve a trigger point, which is a painful area or knot in a muscle.	70	$40	$2.6K
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…	190	$10	$2.3K
J1030	Injection, methylprednisolone acetate, 40 mg	330	$10	$2K
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	90	$1	$90
J2001	Injection, lidocaine hcl for intravenous infusion, 10 mg	330	$0	$0

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. New Jersey Distribution

Paul Nicholas — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,777	13,640	130	$90	$23.6K
99213	3,381	14,090	100	$70	$13.1K
20610	609	1,110	80	$60	$10K
98927	2	30	60	$50	$5.3K
20552	24	140	30	$40	$1.9K
96372	211	1,330	60	$10	$1.3K
J1030	39	500	60	$10	$660
J3420	146	470	50	$1	$100
J2001	4	30	70	$1	$10

Paul Nicholas — Billing Profile & Reimbursement Data

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Paul Nicholas — 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