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

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

David Austin (NPI 1750408985)

Field	Value
Entity Type	Individual
Organization	David Austin
Address	3600 Olentangy River Rd
City	Columbus
State	OH
ZIP	43214
Taxonomy	Orofacial Pain Dentistry
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicare	$73.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	640	$60	$40.9K
21085	The provider fabricates an oral surgical splint to match the patient’s facial contours by taking an impression, or negative imprint, of the patient's face. An oral surgical splint supports a…	30	$510	$14.2K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	910	$10	$8.2K
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	720	$10	$6.5K
99205	The provider sees a new 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 provider…	20	$140	$2.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	50	$20	$970
70360	This procedure is performed to view obstructions within the throat or neck or to visualize suspected foreign bodies.	20	$20	$430
70355	The provider takes panoramic X–rays of the patient’s upper and lower jaws to diagnose a fracture or injury to the jaw.	20	$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 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Ohio Distribution

David Austin — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
21085	1	10	30	$510	$14.2K
97110	1,629	1,680	500	$20	$12.3K
99213	401	20,000	70	$50	$6.6K
99205	1,322	2,130	20	$140	$4.2K
97032	2	40	90	$10	$1.4K
97035	1	80	70	$10	$1K
70355	13	20	20	$10	$280
70360	4	10	20	$10	$190

David Austin — Billing Profile & Reimbursement Data

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David Austin — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References