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

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

Troy Nelson (NPI 1730110206)

Field	Value
Entity Type	Individual
Organization	Troy Nelson
Address	211 S 8th St
City	Mayfield
State	KY
ZIP	42066
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicare	$76.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	350	$140	$48.1K
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…	110	$80	$8.9K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	310	$30	$8.4K
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…	150	$50	$8.1K
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…	30	$90	$2.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	20	$10	$190

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Troy Nelson — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	274	470	170	$70	$24.3K
99308	205	450	130	$50	$14K
99306	2	150	50	$130	$9.3K
99305	73	140	30	$100	$7.6K
99307	28	160	80	$30	$4.7K
80305	207	270	30	$10	$690

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$7M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$6.6M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$5.1M
Arcare	KY	Federally Qualified Health Center (FQHC)	$0	$4.4M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$3.9M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$3.9M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$3.6M
Russell Branum	AR	Rheumatology Physician	$3.1M	$0
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$3M
Arcare	AR	Federally Qualified Health Center (FQHC)	$0	$3M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pinelake Regional Hospital LLC	KY	Rural Acute Care Hospital	$0	$43.3M
Purchase Area Agency On Aging	KY	Supports Brokerage Agency	$0	$30M
Pinnacle Treatment Centers, LLC D/b/a Recovery Works Paducah	KY	Substance Abuse Rehabilitation Facility	$0	$17.7M
Purchase Area Agency On Aging	KY	Supports Brokerage Agency	$0	$12.5M
Pinelake Physician Practice, LLC	KY	Internal Medicine Physician	$0	$4.6M
City Of Mayfield Office Of City Clerk	KY	Land Ambulance	$545.1K	$2M
Air Evac Ems Inc	KY	Air Ambulance	$772K	$828.9K
Tony Smith	KY	Optometrist	$32K	$273.2K
Richard Stone	KY	Family Medicine Physician	$240.7K	$1.6K
Roberto Dos Remedios	KY	Pulmonary Disease Physician	$220.5K	$0

Troy Nelson — Billing Profile & Reimbursement Data

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Troy Nelson — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References