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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Jessica Smith (NPI 1710268891)

Field	Value
Entity Type	Individual
Organization	Jessica Smith
Address	800 N Lake Dr
City	Lexington
State	SC
ZIP	29072
Taxonomy	Occupational Therapist
NPI Enumerated	September 2, 2011

Payer Source	Total Paid
Medicare	$91K
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
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	2,040	$20	$47K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,620	$20	$27.6K
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	490	$20	$9.3K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	90	$70	$6.4K

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. South Carolina Distribution

Jessica Smith — 1 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97530	5	1,250	600	$20	$20K
97110	6	1,390	710	$20	$19.2K
97535	13	250	100	$20	$4.5K
97166	1	80	30	$70	$2.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Medical Management, LLC	SC	Pediatrics Physician	$0	$43.9M
Allcaregivers, Inc.	SC	Nursing Care Agency	$0	$33.3M
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$32M
Lexington County Ems	SC	Ambulance	$2.9M	$6.9M
Lexington Health Inc	SC	Urgent Care Clinic/Center	$0	$8.7M
Key Care Health Services, LLC	SC	Home Health Agency	$0	$8.5M
Capital City Therapy Group, LLC	SC	Specialist	$0	$7.3M
Health Promotion Specialists	SC	Dental Hygienist	$0	$6.5M
Lexington School District One	SC	Local Education Agency (LEA)	$0	$5.7M
Lexington Health Inc	SC	Pediatric Adolescent Medicine Physician	$0	$5.7M

Jessica Smith — Billing Profile & Reimbursement Data

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Jessica 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

Nearby Providers

Frequently Asked Questions

References