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.

Matthew David (NPI 1710333828)

NPI 1710333828 · Rota, XX · Emergency Medicine Physician

Matthew David is a emergency medicine physician provider located in Rota, Unspecified Location. This profile covers 2 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. Note: "XX" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.

NPI 1710333828 · Rota, XX · Emergency Medicine Physician

Provider details (source: NPPES NPI Registry)

Field	Value
Entity Type	Individual
Organization	Matthew David
Address	Apartado De Correos 33
City	Rota
State	XX (Unspecified Location)
ZIP	11530
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 6, 2016

Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

Payer Source	Total Paid
Medicare	$3K
Medicaid	$0

This provider’s Medicare activity is small in absolute dollar terms: lifetime Medicare revenue is $3K, and there is no Medicaid billing on file, making the practice effectively single-payer (Medicare-only) in the available claims records. The absence of any Medicaid revenue indicates that Medicaid does not materially contribute to this provider’s payer mix.

Revenue concentration on Medicare is very high: the precomputed top-3 Medicare codes account for 100.0% of the provider’s total Medicare revenue, with the two listed codes 99285 and 99284 making up the entirety of reported Medicare receipts. This indicates almost all reported Medicare billing is driven by a narrow set of emergency department E/M services.

Business/service-line implications: both top codes (99285 and 99284) are emergency department evaluation and management visits that reflect high- and moderate-complexity ED care respectively. The code mix suggests the provider operates in an emergency medicine role seeing moderate- to high-acuity ED patients rather than performing procedures or prolonged outpatient management.

Code-level revenue detail: 99285 generated $2.1K (69.0% of the provider’s Medicare revenue) from 19 claims at an average paid/claim of $111, while 99284 generated $946 (31.0% of the provider’s Medicare revenue) from 11 claims at an average paid/claim of $86. These two codes together account for 100.0% of Medicare revenue, underscoring that ED E/M visits are the sole sources of billed Medicare income on file.

Competitive standing: for 99285 the provider ranks #55967 of 61347 nationally (8th percentile), and for 99284 the provider ranks #63356 of 64306 nationally (0th percentile). Those percentiles and ranks characterize the provider as a modest participant at the national level for these ED E/M services rather than a high-volume or dominant provider.

Tenure: the provider’s NPI was enumerated on 2016-05-06 (approximately 10 years ago), indicating about a decade of enrollment in the NPI system; despite this tenure, billed Medicare activity is limited in scale based on the lifetime revenue reported.

Operational implication for payers and network planners: given the narrow code mix and low aggregate Medicare revenue, this provider is likely a small-volume emergency medicine clinician within their market. Payors evaluating network adequacy or utilization patterns should treat this profile as representing limited Medicare ED volume and should not infer broad service diversification from the billing on file.

Medicare revenue breakdown by CPT/HCPCS procedure code.

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

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	20	$110	$2.1K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	10	$90	$950

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 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.

Full comparison — all codes billed, vs. state median

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	7	0	N/A	$N/A	$N/A
99285	7	0	N/A	$N/A	$N/A

Matthew David — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References