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

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Marie Francis (NPI 1689043465)

Field	Value
Entity Type	Individual
Organization	Marie Francis
Address	71 Heywood Rd
City	Sterling
State	XX (Unspecified Location)
ZIP	01564
Taxonomy	Family Nurse Practitioner
NPI Enumerated	September 22, 2015

Payer Source	Total Paid
Medicare	$173.4K
Medicaid	$0

Key Findings

This provider’s billing footprint is overwhelmingly Medicare-centric: lifetime Medicare revenue is $173.4K and there is no Medicaid billing on file, so the practice is effectively single-payer in the available claims data. Analysts should therefore treat Medicare reimbursement trends and SNF contract terms as the primary financial drivers for this clinician.

Revenue is highly concentrated in a small set of codes: the precomputed top-3 Medicare codes account for 92.8% of this provider’s total Medicare revenue. That level of concentration indicates the business is dependent on a narrow set of services rather than a broad ambulatory mix.

The code mix points to a nursing-facility–focused practice model. The top codes are 99309, 99308, and 99310 — all subsequent nursing facility care visit E/M codes covering low, moderate, and high levels of medical decision making and/or time — which suggests the provider spends scheduled time on follow-up visits in long-term care or skilled nursing settings.

Top-code volume and payment detail reinforce the SNF focus: 99309 shows 1.2K claims at $72 avg paid/claim generating $85.5K (49.3% of Medicare revenue), 99308 shows 847 claims at $51 avg paid/claim generating $43.2K (24.9%), and 99310 shows 306 claims at $105 avg paid/claim generating $32.1K (18.5%). These three codes alone drive the majority of billed Medicare dollars, consistent with routine, repeated visits rather than episodic procedures.

Competitive standing is modest-to-solid but not dominant nationally for the top codes: 99309 ranks #2416 of 28092 providers (91th percentile, described as "typical, unremarkable volume"), 99308 ranks #3480 of 25763 (86th percentile, "typical, unremarkable volume"), and 99310 ranks #1429 of 12486 (89th percentile, "typical, unremarkable volume"). In plain terms, the provider records higher-than-average activity on these SNF follow-up codes but operates within commonly seen volume ranges rather than as an outlier leader.

Lower-volume initial SNF visit codes show more average national placement: 99306 and 99305 each account for smaller shares ($7.3K/4.2% and $5.3K/3.0% of Medicare revenue respectively) and sit near the middle of national distributions (99306 at the 53th percentile and 99305 at the 58th percentile, both labeled "typical, unremarkable volume"). This suggests the provider’s role is weighted toward ongoing follow-up care rather than initial admissions evaluations.

Tenure and credentials: the NPI was enumerated on 2015-09-22 (~11 years ago) and the taxonomy is Family Nurse Practitioner. The combination of an ~11-year active NPI and a focused SNF E/M code mix supports interpretation of an established clinician providing recurring nursing-facility visits.

From a payer and business risk perspective, the absence of Medicaid billing and heavy dependence on a few Medicare SNF E/M codes means the provider’s revenue is sensitive to Medicare policy changes affecting nursing facility visits and to the stability of SNF referral relationships. Analysts should flag limited payer diversification and concentrated-service exposure when assessing contracting or network inclusion decisions.

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
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1,190	$70	$85.5K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	850	$50	$43.2K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	310	$110	$32.1K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	60	$130	$7.3K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	60	$90	$5.3K

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. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Unspecified Location Distribution

Marie Francis — 3 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	1	10	810	$70	$60.8K
99308	1	10	780	$50	$41.9K
99310	1	10	160	$110	$17.2K
99306	1	10	60	$120	$7.2K
99305	2	10	70	$100	$7K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthdrive Behavioral Health Services, PLLC	CT	Geriatric Psychiatry Physician	$0	$3.2M
Susan Corey	DE	Psychiatric/Mental Health Nurse Practitioner	$134K	$347.4K
Julie Mcgondel	MA	Gerontology Nurse Practitioner	$329.4K	$0
Emelda Njei	DE	Psychiatric/Mental Health Nurse Practitioner	$30K	$297.4K
Stephany Gyasi	MA	Family Nurse Practitioner	$297.5K	$0
Steven Afrow	MA	Gerontology Nurse Practitioner	$212.2K	$0
Nancy Huggins	MA	Nurse Practitioner	$182.9K	$0
Corey Baechel	MA	Clinical Psychologist	$165.1K	$0
Jillian Keigher	RI	Family Nurse Practitioner	$145.3K	$0
Karl Whitlock	GA	Clinical Psychologist	$142.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Horace Mann Educational Assoc., Inc	MA	Developmentally Disabled Services Day Training Agency	$0	$7.3M
James Shenko	MA	Specialist	$46.2K	$0

Marie Francis — Billing Profile & Reimbursement Data

Sign up for Marie Francis — Billing Profile & Reimbursement Data policy alerts

Marie Francis — Billing Profile & Reimbursement Data

Sign up for Marie Francis — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References