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

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

Helene Hughes (NPI 1699773606)

Field	Value
Entity Type	Individual
Organization	Helene Hughes
Address	1141 Clay Ave
City	Dunmore
State	PA
ZIP	18510
Taxonomy	Clinical Social Worker
NPI Enumerated	July 13, 2005

Payer Source	Total Paid
Medicare	$57.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	910	$50	$48.4K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	70	$60	$4.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	40	$80	$3.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	30	$80	$2.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Pennsylvania Distribution

Helene Hughes — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	848	870	180	$100	$23.6K
90834	7	550	110	$70	$11.5K
90791	173	550	20	$110	$5.8K
90847	3	10	40	$70	$4.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Medical Center	PA	General Acute Care Hospital	$0	$22.6M
Julio Ramos	PA	Rheumatology Physician	$1.4M	$550
Shivang Desai	PA	Pain Medicine (Anesthesiology) Physician	$29.7K	$671.7K
Rashita Aggarwal	PA	Internal Medicine Physician	$550.6K	$0
Thomas Dzwonczyk	PA	Cardiovascular Disease Physician	$402.8K	$0
Rajagopalan Rengan	PA	Pulmonary Disease Physician	$360.8K	$0
W Fitzpatrick	PA	Cardiovascular Disease Physician	$279.3K	$0
Matthew Stopper	PA	Cardiovascular Disease Physician	$225K	$0
Roger Getts	PA	Nephrology Physician	$223.6K	$0
Nishant Sethi	PA	Interventional Cardiology Physician	$223.5K	$0

Helene Hughes — Billing Profile & Reimbursement Data

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Helene Hughes — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References