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

Why is the Medicaid comparison limited to Michigan 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. Michigan (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 Edwards (NPI 1659431054)

Field	Value
Entity Type	Individual
Organization	Paul Edwards
Address	Henry Ford Health System
City	Detroit
State	MI
ZIP	48202
Taxonomy	Ophthalmology Physician
NPI Enumerated	December 8, 2006

Payer Source	Total Paid
Medicare	$21.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 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…	110	$70	$7.4K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	90	$80	$7K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	250	$20	$4.5K
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…	50	$50	$2.3K
92228	The patient undergoes retinal imaging on one or both eyes in a location other than the reviewing provider’s location. The provider interprets the images remotely and prepares a report. The imaging…	20	$10	$220

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Michigan Distribution

Paul Edwards — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
67028	128	160	440	$90	$57.6K
99214	6,092	15,470	80	$80	$11.4K
92134	165	820	60	$30	$7.1K
99213	8,970	14,810	60	$60	$6.6K
92228	2	10	20	$10	$250

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Hessburg	MI	Ophthalmology Physician	$132.2K	$0
Taylor Fields	MI	Ophthalmology Physician	$39.4K	$0
Ross Mayerhoff	MI	Otolaryngology Physician	$28.3K	$0

Paul Edwards — Billing Profile & Reimbursement Data

Sign up for Paul Edwards — Billing Profile & Reimbursement Data policy alerts

Paul Edwards — Billing Profile & Reimbursement Data

Sign up for Paul Edwards — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References