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

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

Kathryn Herndon (NPI 1679567150)

Kathryn Herndon is a interventional pain medicine physician provider located in Gainesville, Georgia. This profile covers 15 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Kathryn Herndon
Address	530 Spring St Se
City	Gainesville
State	GA
ZIP	30501
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	September 9, 2005

Payer Source	Total Paid
Medicare	$93.8K
Medicaid	$0

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

15 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…	600	$90	$53.2K
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…	230	$60	$13.4K
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…	50	$130	$6.4K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	70	$70	$5.3K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	30	$190	$4.9K
J7321	Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	50	$60	$2.9K
62321	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the cervical (neck) or thoracic (upper and middle back)…	10	$190	$2.3K
J0702	Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	290	$10	$1.4K
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…	10	$120	$1.3K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	50	$30	$1.2K

Showing 1–10 of 15

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,099	13,640	120	$80	$17.8K
62323	206	280	40	$150	$9.3K
99213	2,774	13,360	80	$60	$9.2K
J7321	71	80	90	$60	$8.5K
99215	1,147	3,270	30	$120	$7.7K
62321	229	230	30	$160	$7.1K
20611	66	190	50	$70	$6.1K
99204	6,980	7,260	30	$110	$5.1K
G0396	9	20	50	$20	$1.8K
76881	31	40	20	$40	$1.3K

Kathryn Herndon — Billing Profile & Reimbursement Data

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Kathryn Herndon — 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