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

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

Benjamin Nelson (NPI 1750465985)

Field	Value
Entity Type	Individual
Organization	Benjamin Nelson
Address	400 East 3rd Street
City	Duluth
State	MN
ZIP	55805
Taxonomy	Sports Medicine (Family Medicine) Physician
NPI Enumerated	October 24, 2006

Payer Source	Total Paid
Medicare	$9.2K
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
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	60	$30	$2.1K
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…	30	$70	$1.9K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	40	$40	$1.5K
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…	30	$40	$1.3K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	30	$40	$1.1K
99204	The provider sees a new 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 provider…	10	$60	$700
99203	The provider sees a new 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 provider…	10	$60	$680

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. Minnesota Distribution

Benjamin Nelson — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	7,952	10,100	70	$80	$8.1K
20611	112	170	40	$70	$5.5K
99213	5,641	9,120	50	$50	$4K
99204	3,138	3,340	20	$110	$3.6K
20610	401	860	40	$40	$2.7K
99203	2,339	2,690	20	$70	$2.3K
76881	4	20	40	$40	$1.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Duluth Clinic, Ltd	MN	Multi-Specialty Clinic/Center	$0	$51.7M
Smdc Medical Center	MN	General Acute Care Hospital	$0	$35.3M
St Marys Medical Center	MN	General Acute Care Hospital	$0	$21M
St. Mary's Hospital Of Superior	WI	Critical Access Hospital	$0	$13.4M
Essentia Health Virginia, LLC	MN	General Acute Care Hospital	$0	$12.9M
Essentia Health Virginia, LLC	MN	Rural Health Clinic/Center	$0	$5.6M
St. Mary's Duluth Clinic Health System	MN	Clinical Medical Laboratory	$260.2K	$5M
Deer River Healthcare Center, Inc.	MN	Critical Access Hospital	$0	$4.6M
John Thompson	MD	Ophthalmology Physician	$3.9M	$0
St. Mary's Hospital Of Superior	WI	Critical Access Hospital Clinic/Center	$0	$1.6M

Benjamin Nelson — Billing Profile & Reimbursement Data

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Benjamin 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

Frequently Asked Questions

References