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    OpenPayerNPI Medicare & MedicaidStephen Smith
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    Stephen Smith — Billing Profile & Reimbursement Data

    NPI 1710969670 · Holden, MA · Family Medicine Physician

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    Stephen Smith is a family medicine physician provider located in Holden, Massachusetts. This profile covers 12 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationStephen Smith
    Address27 Shrewsbury St
    CityHolden
    StateMA
    ZIP01520
    TaxonomyFamily Medicine Physician
    NPI EnumeratedNovember 16, 2005

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

    Payer SourceTotal Paid
    Medicare$88K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    12 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…430$80$36.3K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit200$130$25.9K
    90677This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…30$280$9.2K
    90694This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…70$80$5K
    G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit20$170$3.5K
    G0008Administration of influenza virus vaccine70$30$2.4K
    G0402Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment10$170$1.9K
    G0180Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review…30$40$1.3K
    G0009Administration of pneumococcal vaccine30$30$1.1K
    99213The 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…20$60$1K

    Showing 1–10 of 12

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    12 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992141,57215,410110$80$15.6K
    G04393993,35070$120$11.9K
    904801,0791,130160$40$9.4K
    9921312,25013,70070$60$8.8K
    906946371,53050$70$8.6K
    906774031,81020$280$7.7K
    G043819355020$160$3.8K
    G00081,1703,49040$30$3.5K
    G040231539010$170$2.6K
    G018032292030$40$1.4K

    Showing 1–10 of 12

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Reliant Medical Group, IncMAFamily Medicine Physician$0$101.8M
    Bryan HongMARetina Specialist (Ophthalmology) Physician$2.5M$0
    Brad BakerMARetina Specialist (Ophthalmology) Physician$2.5M$0
    Frank MccabeMARetina Specialist (Ophthalmology) Physician$1.5M$0
    Yuyang ZhangMDDiagnostic Radiology Physician$920.4K$0
    Tony SamahaMAHematology & Oncology Physician$813.5K$0
    Karen Jeng-millerMAOphthalmology Physician$698.7K$0
    Vincent ChampionNCDiagnostic Radiology Physician$406.6K$166.9K
    Bradley SwitzerMAInternal Medicine Physician$524.2K$0
    Miin RohMAOphthalmology Physician$510.9K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Sunita GodiwalaMAFamily Medicine Physician$146.4K$95.4K
    Maria PappasMAPhysical Therapist$120.5K$0
    Robert CookeMAPhysician Assistant$61.5K$500
    Karen-whitley BishopMAPhysician Assistant$57.2K$0
    William O'callahanMAEmergency Medicine Physician$55.8K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Massachusetts Distribution
    Stephen Smith — 0 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Massachusetts