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

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

Thomas Jones (NPI 1770654576)

Field	Value
Entity Type	Individual
Organization	Thomas Jones
Address	13823 Tamiami Trl
City	North Port
State	FL
ZIP	34287
Taxonomy	Physician Assistant
NPI Enumerated	November 13, 2006

Payer Source	Total Paid
Medicare	$123.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	980	$80	$75.5K
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…	150	$90	$13.1K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	190	$50	$9.6K
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…	170	$40	$7.2K
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…	60	$110	$6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	90	$40	$3K
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…	50	$40	$1.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	140	$10	$1.3K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	80	$20	$1.2K
87086	Culture, bacterial; quantitative, colony count, urine.	100	$10	$770

Showing 1–10 of 26

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 26 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Thomas Jones — 2 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

26 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,936	32,760	140	$90	$25K
80053	1,403	1,430	170	$10	$21.3K
87186	59	240	30	$10	$15.4K
99213	9,253	30,010	80	$60	$12K
85025	1,904	1,930	210	$10	$11.5K
99215	3,316	8,550	40	$130	$10.7K
87086	84	400	40	$10	$9.7K
87077	47	240	30	$10	$7.1K
99204	1,640	19,040	40	$110	$7K
36415	5,805	6,020	80	$10	$5K

Showing 1–10 of 26

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Juan Masi	FL	Internal Medicine Physician	$437.2K	$0
Noelis Jennings Rosario	FL	Foot & Ankle Surgery Podiatrist	$339.7K	$0
Porur Somasundaram	FL	Clinical Cardiac Electrophysiology Physician	$225.7K	$0
Ociel Betancourt	FL	Physical Therapist	$210.5K	$0
David Danielson	FL	Foot & Ankle Surgery Podiatrist	$184.2K	$0
Ovidiu Grigoras	FL	Family Medicine Physician	$156.2K	$0
Kalyani Regeti	FL	Endocrinology, Diabetes & Metabolism Physician	$150.2K	$0

Thomas Jones — Billing Profile & Reimbursement Data

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Thomas Jones — 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