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

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

Phillip Zhang (NPI 1619363231)

Phillip Zhang is a rheumatology physician provider located in New Haven, Connecticut. This profile covers 11 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Phillip Zhang
Address	20 York St
City	New Haven
State	CT
ZIP	06510
Taxonomy	Rheumatology Physician
NPI Enumerated	April 10, 2015

Payer Source	Total Paid
Medicare	$15K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	90	$90	$7.3K
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…	30	$110	$3.8K
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	$60	$1.3K
86235	The lab analyst performs an assay to evaluate the patient’s serum for each antibody to an extractable nuclear antigen, also called ENA. Types of ENA antibodies include anti ribonuclear protein,…	40	$20	$630
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	60	$10	$510
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	50	$10	$450
86140	The lab analyst performs the technical lab test to analyze a specimen, typically serum, for the presence of C reactive protein.	60	$10	$300
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	40	$10	$290
86200	The lab analyst performs a technical lab test to detect cyclic citrullinated peptide, or CCP, antibody, typically in serum. CCP antibodies typically indicate and differentiate rheumatoid arthritis,…	10	$10	$170
85652	The lab analyst performs a test on patient blood to evaluate the rate of sedimentation of red blood cells using an automated test platform.	60	$1	$120

Showing 1–10 of 11

Phillip Zhang — 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

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	3,366	6,480	90	$90	$14.2K
99213	5,575	6,440	70	$60	$8.1K
86235	2	10	260	$20	$4.6K
99204	1,006	2,660	30	$120	$4.6K
80053	188	240	90	$10	$2.5K
85025	196	250	90	$10	$2.1K
36415	282	570	60	$10	$1.7K
86200	2	10	60	$10	$770
86140	3	20	20	$10	$530
86431	4	10	90	$10	$490