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

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

John Smith (NPI 1669402582)

Field	Value
Entity Type	Individual
Organization	John Smith
Address	104 Morris Cir
City	Homer
State	LA
ZIP	71040
Taxonomy	Family Medicine Physician
NPI Enumerated	July 4, 2006

Payer Source	Total Paid
Medicare	$102.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

32 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…	360	$60	$19.7K
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…	210	$80	$16.7K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	90	$140	$12.2K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	80	$110	$9.1K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	90	$90	$8.2K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	30	$120	$3.6K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	120	$30	$3.5K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	180	$20	$2.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	190	$10	$2.4K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	20	$150	$2.4K

Showing 1–10 of 32

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 32 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Louisiana Distribution

John Smith — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. state median

32 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	528	1,090	90	$140	$17.3K
99214	2,084	6,670	110	$80	$16.5K
87631	10	10	30	$140	$12.6K
G0439	444	1,060	60	$120	$11.7K
99215	1,497	1,650	40	$110	$8.4K
99213	638	6,060	70	$50	$8.1K
99284	293	1,150	50	$90	$5.8K
84443	115	300	120	$20	$5.1K
82306	59	200	60	$30	$5.1K
G0438	181	220	20	$150	$5.1K

Showing 1–10 of 32

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Bernard	LA	Family Medicine Physician	$143.1K	$0
Chesley Gregory	LA	Family Medicine Physician	$61.7K	$800

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Ingenuity Inc	LA	Developmentally Disabled Services Day Training Agency	$0	$25.8M
Homer Memorial Hospital	LA	General Acute Care Hospital	$0	$5.8M
Ashley Thomas	LA	Family Nurse Practitioner	$25.7K	$420.5K
Ekara Wafer-mendenhall	LA	Nurse Practitioner	$69.1K	$0
Clifton Salmon	LA	Family Medicine Physician	$49.1K	$0
Patrick Clawson	LA	Chiropractor	$32.3K	$0
Harold Tyler	LA	General Practice Physician	$12.4K	$0

John Smith — Billing Profile & Reimbursement Data

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John 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