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

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

Cynthia Thomas (NPI 1780868125)

Field	Value
Entity Type	Individual
Organization	Cynthia Thomas
Address	2339 Cedar Rdg
City	Green Bay
State	WI
ZIP	54313
Taxonomy	Social Worker
NPI Enumerated	December 20, 2007

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	6,020	$80	$481.5K
0365T	Adaptive behavior tx addl	1,250	$240	$301.5K
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	3,140	$70	$216.7K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	2,260	$30	$74.4K
0369T	Duodenal mucosal resurfacing, endoscopic	600	$100	$58.2K
0364T	Behavior treatment	1,220	$50	$56.2K
0368T	Behavior treatment modified additional	620	$40	$21.6K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	160	$100	$15.3K
97158	The provider administers adaptive behavior treatment to multiple patients in a social skills group. Report this code for each 15 minutes that the provider spends face–to–face with multiple patients…	70	$30	$2.3K
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…	20	$70	$1.6K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Wisconsin providers billing the same CPT/HCPCS codes.

Claims Volume vs. Wisconsin Distribution

Cynthia Thomas — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	73	110	5,170	$80	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	17	110	2,070	$120	$581.8K
0365T	Adaptive behavior tx addl	38	50	3,570	$70	$305.2K
0369T	Duodenal mucosal resurfacing, endoscopic	33	50	1,180	$100	$155.8K
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…	856	900	410	$70	$130.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	543	790	400	$40	$109.6K
0364T	Behavior treatment	39	50	3,670	$10	$68.2K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	9	80	200	$70	$60.4K
0368T	Behavior treatment modified additional	33	50	1,190	$30	$50K
97151	The provider, a physician or other qualified healthcare professional, identifies the adaptive or maladaptive behavior of the patient by administering several different types of tests in person; he…	24	50	160	$90	$34.6K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Innovative Counseling Inc	WI	Community/Behavioral Health Agency	$0	$2.2M
Joseph Hoelscher	WI	Clinical Social Worker	$29.3K	$2.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Gast	WI	Family Medicine Physician	$279.9K	$36.6K
Gina Spohn	WI	Dermatology Physician	$139.3K	$0
Kurt Holst	WI	Physician Assistant	$77.3K	$0
James Kribs	WI	Neuromusculoskeletal Medicine & OMM Physician	$56.4K	$0
Dhwani Vaishnav	WI	Family Medicine Physician	$52.9K	$0
Blake Lemke	WI	Family Medicine Physician	$26.6K	$0
Victoria Romanski	WI	Family Nurse Practitioner	$12.6K	$0
Jennifer Taber	WI	Occupational Therapist	$9K	$0

Cynthia Thomas — Billing Profile & Reimbursement Data

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Cynthia Thomas — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References