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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

Grace Macalalag (NPI 1730611666)

Field	Value
Entity Type	Individual
Organization	Grace Macalalag
Address	239 Morris Ave
City	Summit
State	NJ
ZIP	07901
Taxonomy	Acute Care Nurse Practitioner
NPI Enumerated	March 30, 2017

Payer Source	Total Paid
Medicare	$11.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	30	$150	$5K
36556	The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.	50	$60	$3.2K
36620	In this procedure, the provider inserts a catheter percutaneously (through the skin) into an artery and uses this catheter for the purpose of sampling, transfusion, or continuous real–time blood…	40	$30	$1.2K
31500	The provider inserts a flexible tube into the trachea (windpipe) typically via the mouth in an emergency situation to maintain an open airway in a patient with a compromised airway.	10	$100	$1.1K
76937	The provider uses ultrasound to help guide procedures requiring vascular access including central venous, peripheral venous, or arterial access procedures.	80	$10	$800

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Jersey Distribution

Grace Macalalag — 1 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	1,249	1,970	50	$180	$16.1K
31500	48	60	10	$120	$1.8K
36556	10	200	20	$70	$1.6K
36620	37	200	20	$40	$1K
76937	55	360	30	$20	$820

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahs Hospital Corp.	NJ	General Acute Care Hospital	$0	$125.2M
Emergency Physician Associates Of North Jersey P C	NJ	Emergency Medicine Physician	$0	$16.5M
Mark Krell	NJ	Cardiovascular Disease Physician	$448.6K	$0
John Williams	NJ	Dermatology Physician	$315K	$0
John Werring	NJ	Diagnostic Radiology Physician	$209.8K	$0
Miles Levin	NJ	Anatomic Pathology & Clinical Pathology Physician	$207.8K	$0
Prabha Pai	NJ	Anatomic Pathology & Clinical Pathology Physician	$199.5K	$0
Christine Stahl	NJ	Neurology Physician	$190.4K	$0
Hamid Bagce	NJ	Diagnostic Radiology Physician	$164.2K	$730
Edward Dimitry	NJ	Pulmonary Disease Physician	$160.5K	$0

Grace Macalalag — Billing Profile & Reimbursement Data

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Grace Macalalag — 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