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

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

Marcia Malone (NPI 1740803022)

Field	Value
Entity Type	Individual
Organization	Marcia Malone
Address	5045 S 153rd St
City	Omaha
State	NE
ZIP	68137
Taxonomy	Nurse Practitioner
NPI Enumerated	May 21, 2020

Payer Source	Total Paid
Medicare	$31.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0108	Diabetes outpatient self-management training services, individual, per 30 minutes	380	$40	$15K
99214	The 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…	140	$70	$10.4K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	$110	$3.6K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	60	$20	$1.3K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	70	$10	$720
99213	The 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	$40	$690
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	30	$10	$200

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Nebraska Distribution

Marcia Malone — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,311	3,210	110	$70	$14.9K
99213	3,002	3,220	90	$50	$7.9K
99215	502	920	40	$110	$7K
G0108	1	10	160	$40	$6.7K
95251	35	50	100	$20	$3K
36415	949	1,120	130	$10	$2K
83036	280	520	80	$10	$1.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sakrx, LLC	NE	Durable Medical Equipment & Medical Supplies	$554.5K	$9.6M
Connected Roots Care Center	NE	Medically Fragile Infants and Children Day Care	$0	$7.7M
Procare3, Inc.	NE	Rehabilitation Practitioner	$0	$4M
Kohlls Pharmacy & Homecare Inc	NE	Durable Medical Equipment & Medical Supplies	$0	$2.8M
Omaha Treatment Center, LLC	NE	Methadone Clinic	$66.3K	$2.1M
Oneworld Community Health Centers, Inc.	NE	Community Health Clinic/Center	$0	$1.7M
Vance Thompson Vision Surgery Center Ne, LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$0
Option Care Enterprises, Inc.	NE	Home Infusion Therapy Pharmacy	$0	$1.5M
Total Respiratory And Rehab Inc	NE	Durable Medical Equipment & Medical Supplies	$0	$1.2M
Adultspan PC	NE	Mental Health Counselor	$0	$705.2K

Marcia Malone — Billing Profile & Reimbursement Data

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Marcia Malone — 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