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

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

Teresa Golden (NPI 1669568697)

Field	Value
Entity Type	Individual
Organization	Teresa Golden
Address	2542 Langhorne Rd
City	Lynchburg
State	VA
ZIP	24501
Taxonomy	Nurse Practitioner
NPI Enumerated	October 5, 2006

Payer Source	Total Paid
Medicare	$22.5K
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…	130	$70	$8.7K
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…	170	$50	$8.7K
51702	The bladder catheter CPT® codes provide options for reporting the procedures that best reflect the exact anatomic location of a catheter insertion, the type of catheter inserted, and, in some cases,…	40	$40	$1.4K
99203	The provider sees a new 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 provider…	20	$60	$1.2K
74018	Report this code for one X–ray view of the structures and organs in the abdomen to diagnose certain abdominal problems.	70	$20	$1.1K
81015	The lab analyst performs this testing based on the specific order for a microscopic urinalysis only. The lab analyst will examine a urine specimen directly under the microscope or by using the…	250	$1	$750
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	70	$10	$500

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. Virginia Distribution

Teresa Golden — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	6,621	12,890	140	$80	$21K
99213	3,857	12,440	90	$60	$10K
99203	3,446	4,920	30	$70	$3.8K
51702	58	160	30	$40	$1.6K
51798	192	260	150	$10	$1.6K
74018	298	650	60	$10	$900
81015	5	20	40	$1	$630

Teresa Golden — Billing Profile & Reimbursement Data

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Teresa Golden — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References