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

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

St Paul Place Specialists, Inc. (NPI 1639189863)

St Paul Place Specialists, Inc. is a dermatology physician provider located in Baltimore, Maryland. This profile covers 0 Medicare and 69 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	St Paul Place Specialists, Inc.
Address	301 St Paul Place
City	Baltimore
State	MD
ZIP	21202
Taxonomy	Dermatology Physician
NPI Enumerated	August 9, 2006

Payer Source	Total Paid
Medicaid	$13.3M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

69 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…	41,540	$80	$3.3M
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…	22,160	$90	$2M
93976	The provider performs a duplex scan of a single organ or a limited area of the abdominal, pelvic, scrotal, or retroperitoneal organs. He performs the procedure to examine the vascular supply to the…	16,610	$60	$913.7K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	27,480	$30	$769.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	15,250	$40	$579.5K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	590	$860	$510.3K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	11,470	$40	$504.5K
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…	2,980	$120	$352K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	8,780	$40	$324.8K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3,480	$90	$316.4K

Showing 1–10 of 69

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maryland Distribution

St Paul Place Specialists, Inc. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

69 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	71	3,670	680	$90	$310K
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…	40	3,280	610	$80	$296.1K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	6	30	670	$130	$291.4K
93976	The provider performs a duplex scan of a single organ or a limited area of the abdominal, pelvic, scrotal, or retroperitoneal organs. He performs the procedure to examine the vascular supply to the…	2	20	280	$70	$290.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	3	20	60	$810	$256.6K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	7	10	1,680	$50	$242.7K
99233	The provider sees a patient for a subsequent 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	300	420	$50	$213.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	4	60	370	$70	$195.6K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	3	40	250	$40	$190.6K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	2	20	450	$60	$184.1K

Showing 1–10 of 69

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Morris	MD	Diagnostic Radiology Physician	$12M	$0
Richard Huslig	MD	Hematology & Oncology Physician	$4.9M	$0
St Paul Place Specialists, Inc.	MD	Clinical Pathology/Laboratory Medicine Physician	$2.7M	$948.8K
Panayotis Ledakis	MD	Hematology & Oncology Physician	$3M	$0
Jaideep Sohi	IL	Nuclear Radiology Physician	$1.5M	$6.9K
Kelly Orwat	SC	Internal Medicine Physician	$1.3M	$0
Jonathan Breslau	MN	Diagnostic Radiology Physician	$1.3M	$0
Muhammad Saad Khan	IL	Hematology & Oncology Physician	$1.3M	$0
Stephen Ronson	MD	Specialist	$1.2M	$0
Pavni Patel	MD	Nuclear Medicine Physician	$1.1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baltimore City Schools	MD	Local Education Agency (LEA)	$0	$95.8M
Mayor And City Council Of Baltimore	MD	Land Ambulance	$6.3M	$38M
Health Care For The Homeless, Inc	MD	Federally Qualified Health Center (FQHC)	$0	$26.8M
Maryland Family Care, Inc.	MD	Family Medicine Physician	$0	$24.6M
Hope Resource Center, LLC	MD	Community/Behavioral Health Agency	$0	$18.1M
Pha Healthcare LLC	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$18M
Lighthouse Behavioral Health Center, LLC	MD	Substance Abuse Rehabilitation Facility	$0	$11.5M
Emergency Physicians Spps	MD	Emergency Medicine Physician	$0	$9.8M
Heavens Place-outpatient Detox & Recovery Center	MD	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.6M
S K Pesis Dds, Big Smiles Maryland, PC	MD	Dentist	$0	$6.9M

St Paul Place Specialists, Inc. — Billing Profile & Reimbursement Data

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St Paul Place Specialists, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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