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

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

Richard James (NPI 1750325262)

Field	Value
Entity Type	Individual
Organization	Richard James
Address	1107 Hound Dog Trl
City	Saint Helen
State	MI
ZIP	48656
Taxonomy	Psychologist
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicare	$69.2K
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
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	190	$110	$21.7K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	130	$90	$11.6K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	130	$90	$11.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	100	$110	$10.9K
96133	The provider, a physician or other qualified healthcare professional, administers neuropsychological tests, face–to–face with the patient. Report this code in addition to the primary code (96132) for…	120	$60	$7.6K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	100	$60	$6K

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. Michigan Distribution

Richard James — 1 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Michigan

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	380	580	140	$90	$18.8K
96133	30	90	90	$70	$8.8K
96130	4	40	30	$90	$5.4K
96132	6	100	40	$90	$4.6K
90791	13	420	20	$110	$4.6K
96131	3	20	40	$60	$4.3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Giancarlo	MI	Neurology Physician	$458.1K	$0
Shawn Edgington	GA	Professional Counselor	$0	$405K
Terri White	GA	Professional Counselor	$0	$386.1K
Carl Alsterberg	MI	Clinical Psychologist	$345.3K	$0
Ross Halpern	MI	Psychologist	$296.7K	$0
George Dillon	MI	Vascular Neurology Physician	$218.5K	$0
James Mccray	GA	Professional Counselor	$0	$190.8K
Daniel Grasso	MI	Psychiatric/Mental Health Nurse Practitioner	$178.3K	$0
Sarah Parsons	KY	Psychiatry Physician	$151.4K	$0
Taranjeet Jolly	MD	Pain Medicine Physician	$36.4K	$99.3K

Richard James — Billing Profile & Reimbursement Data

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Richard James — 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

Frequently Asked Questions

References