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

Why is the Medicaid comparison limited to Pennsylvania 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. Pennsylvania (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 Smith (NPI 1639205206)

Field	Value
Entity Type	Individual
Organization	Paul Smith
Address	1100 Grampian Blvd
City	Williamsport
State	PA
ZIP	17701
Taxonomy	Occupational Medicine Physician
NPI Enumerated	February 26, 2007

Payer Source	Total Paid
Medicare	$18.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 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…	130	$60	$7.8K
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…	50	$130	$6.7K
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…	40	$100	$3.9K
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an…	20	$10	$200

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Paul Smith — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,046	23,230	100	$80	$14.5K
99213	488	22,370	70	$60	$7.7K
99204	177	10,290	30	$110	$5K
G2012	5	30	30	$10	$370

Related Providers

Other providers that share a Tax Identification Number (TIN) with Paul Smith, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
University Of Pittsburgh Physicians	PA	Psychiatry Physician	$0	$26.4M
University Of Pittsburgh Physicians	PA	Specialist	$0	$23.6M
Ashok Muthukrishnan	FL	Nuclear Radiology Physician	$3.9M	$129.2K
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Chase Contino	PA	Clinical Cardiac Electrophysiology Physician	$538.3K	$0
Sabrina Mikita	PA	Dermatology Physician	$239.2K	$184.3K
John Bailey	PA	Orthopaedic Surgery Physician	$389.2K	$21.4K
Melissa Tavarez	DC	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$390.9K
Jack Smith	PA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$344.5K	$0

Nearby Providers

Other providers in the same ZIP code as Paul Smith, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope Enterprises, Inc.	PA	Voluntary or Charitable Agency	$0	$36.1M
River Valley Health	PA	Federally Qualified Health Center (FQHC)	$0	$22.2M
Bayada Home Health Care, Inc.	PA	Home Health Agency	$0	$17.6M
Crossroads Counseling, Inc	PA	Clinic/Center	$0	$11.2M
Pediatric Services Of America, LLC	PA	Home Health Agency	$0	$10.8M
Upmc Williamsport	PA	General Acute Care Hospital	$0	$9.7M
Diakon Child, Family & Community Ministries	PA	Community/Behavioral Health Agency	$0	$9.1M
Lycoming-clinton Joinder Board	PA	Case Management Agency	$0	$8.4M
Lycoming-clinton Mhmr Program	PA	Psychologist	$0	$7.8M
Maxim Healthcare Services, Inc.	PA	Home Health Agency	$0	$7.7M

Paul Smith — Billing Profile & Reimbursement Data

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Paul Smith — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References