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

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

Michael Loughner (NPI 1639216906)

Field	Value
Entity Type	Individual
Organization	Michael Loughner
Address	950 E Harvard Ave
City	Denver
State	CO
ZIP	80210
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	January 30, 2007

Payer Source	Total Paid
Medicare	$139.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 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…	1,070	$90	$95.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	80	$140	$10.9K
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…	70	$120	$8.5K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	290	$30	$7.8K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	80	$80	$6.6K
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…	90	$60	$5.6K
10005	Under ultrasound guidance, the provider performs a fine needle aspiration (FNA), a diagnostic procedure that involves collecting a specimen from tissue, a cyst, or mass using a specialized needle and…	30	$110	$3.8K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Colorado Distribution

Michael Loughner — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	32	8,160	80	$80	$11.3K
99215	877	3,230	40	$110	$8.1K
99213	2,792	7,200	70	$60	$6.6K
99204	550	3,670	30	$110	$4.7K
95251	3	80	80	$30	$2.5K
76536	18	230	30	$50	$2K
10005	6	50	20	$60	$1.3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kenneth Tompkins	CO	Internal Medicine Physician	$72.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Guardian Recovery - Curawest, LLC	CO	Substance Abuse Rehabilitation Facility	$0	$5.9M
Kidscare Therapy Of Colorado, LLC	CO	Home Health Agency	$0	$5.3M
Peter Hovland	CO	Ophthalmology Physician	$1.8M	$0
Yousuf Gaffar	CO	Hematology & Oncology Physician	$1.5M	$0
Harvard Park Surgery Center, LLC	CO	Ambulatory Surgical Clinic/Center	$925.7K	$535.2K
James Swinehart	CO	Specialist	$423.6K	$0
Carl Demidovich	CO	Dermatology Physician	$346.8K	$0
Adam Wolff	CO	Neurology Physician	$337.9K	$0
Jason Jacobs	CO	Ophthalmology Physician	$281.7K	$0
Justin Moon	CO	Neurology Physician	$275.9K	$0

Michael Loughner — Billing Profile & Reimbursement Data

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Michael Loughner — 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