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

Why is the Medicaid comparison limited to Mississippi 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. Mississippi (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 Roy (NPI 1801097019)

Field	Value
Entity Type	Individual
Organization	David Roy
Address	201 S Main St
City	Petal
State	MS
ZIP	39465
Taxonomy	MOHS-Micrographic Surgery Physician
NPI Enumerated	May 29, 2007

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

This provider’s public-payer footprint is effectively single‑payer: lifetime Medicare revenue is $1.2M while there is no Medicaid billing on file, and the NPI has been enumerated since 2007-05-29 (~19 years ago), indicating a long-tenured Medicare billing history. The absence of Medicaid activity means risk and utilization analyses should focus on Medicare-only patterns for public programs.

Revenue is highly concentrated in a small set of services: the top 3 Medicare codes account for 48.7% of this provider’s total Medicare revenue, led by 17311 at $270.9K (24.7% of Medicare revenue), followed by 77280 at $154.7K (14.1%) and G6001 at $109.2K (9.9%). This concentration implies that payer negotiations or utilization management targeting those codes would influence a large share of the provider’s Medicare revenue.

The code mix strongly reflects MOHS and reconstructive surgical activity: Mohs codes 17311, 17313, and 17312 together represent substantial Medicare revenue with 17311 alone contributing $270.9K (24.7%). This aligns with the provider taxonomy MOHS-Micrographic Surgery Physician and suggests a practice model centered on staged excision with follow-on reconstructive repairs reported by multiple high-volume repair codes.

There is a notable radiation-therapy services footprint in the billing mix: 77280 (simulation) and G6001 (ultrasonic guidance) are among the top revenue codes, with 77280 at $154.7K ranking #125 of 3348 nationally (96th percentile; notably above typical national volume for this code) and G6001 at $109.2K ranking #96 of 280 (66th percentile; typical, unremarkable volume for this code). This pattern suggests either direct provision of simulation/guidance services or close affiliation with radiation therapy operations, and it warrants review when assessing referral networks or service line overlaps.

For competitive standing, the provider shows mixed national positioning across services: 17311 ranks #296 of 2969 (90th percentile; typical, unremarkable volume for this code), indicating solid Mohs activity but not dominance, while several reconstructive repair codes such as 13132 and 13121 rank in the 98th percentile (e.g., 13132 ranks #67 of 3088; notably above typical national volume for this code), signaling unusually high volumes in complex repairs relative to national peers. Analysts should treat the provider as a high-volume specialist for certain reconstructive procedures but a more average performer on the principal Mohs code by national benchmarks.

Pathology and E/M billing patterns reflect routine surgical practice support: 88305 shows 2.5K claims for $55.8K (5.1% of Medicare revenue) and is described as 91th percentile (typical, unremarkable volume for this code), while 99213 has 736 claims for $43.4K (4.0% of Medicare revenue) and ranks in the 97th percentile (notably above typical national volume for this code). The combination of many low‑paid pathology claims and high-volume mid-level E/M visits is consistent with an active surgical practice that generates substantial downstream specimen processing and follow-up office care.

Operational and payer implications include the fact that a few outpatient surgical and radiation-related codes drive a large share of Medicare revenue, so utilization shifts in those categories could materially affect the provider’s Medicare spend profile. Given the lack of Medicaid billing, contracting or risk-sharing conversations with public programs will be dominated by Medicare exposure, and payers should prioritize audit/benchmarking of top drivers such as 17311, 77280, and G6001 (the precomputed top-three share of 48.7%).

One administrative note of potential relevance to claims reviewers: code 77401 appears on file with 800 claims and $22.4K revenue (2.0% of Medicare revenue) but is listed as deleted effective Jan. 1, 2026, which may affect historical comparisons and requires coding transition review for post‑2025 activity.

Medicare: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17311	Mohs surgery is a multi–staged procedure that is performed to excise a malignant lesion layer by layer, along with histo–pathological assessment. The assessment is performed to ensure that the…	640	$430	$270.9K
77280	The provider uses a simulator or other imaging modality to determine the size and location of ports to be used for radiation therapy. This code describes a simple level service.	820	$190	$154.7K
G6001	Ultrasonic guidance for placement of radiation therapy fields	870	$130	$109.2K
17313	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	180	$390	$72.1K
17312	Mohs surgery is a multi–staged method of excising a malignant lesion layer by layer, along with histo–pathological assessment, to ensure negative malignancy of the margins.	210	$300	$62.2K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	350	$170	$60.4K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	2,540	$20	$55.8K
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…	740	$60	$43.4K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	240	$170	$40.9K
17108	Cutaneous vascular destruction is generally performed with a laser (e.g. Argon, pulsed dye, and YAG). This is a bloodless surgery due to the fact that there is no incision made in the skin. This…	70	$440	$32.6K

Showing 1–10 of 51

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 51 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Mississippi Distribution

David Roy — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. state median

51 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17311	4	20	260	$410	$155.1K
G6001	3	10	870	$130	$116.7K
17312	7	20	190	$290	$53.5K
14061	10	10	30	$600	$52.6K
88305	14	90	620	$30	$44.3K
77427	26	30	260	$140	$39.7K
17313	1	10	60	$400	$32.9K
77280	3	30	60	$150	$32.9K
17108	1	10	70	$440	$32.6K
99214	1,221	4,110	170	$70	$21.9K

Showing 1–10 of 51

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Central Regional Medical Center	MS	General Acute Care Hospital	$0	$48.1M
South Central Clinics, Inc	MS	Emergency Medicine Physician	$0	$4.5M
South Central Clinics, Inc	MS	Rural Health Clinic/Center	$0	$4.4M
South Central Clinics, Inc.	MS	Rural Health Clinic/Center	$0	$3.8M
South Central Clinics, Inc	MS	Rural Health Clinic/Center	$0	$3.3M
South Central Clinics, Inc	MS	Hospitalist Physician	$0	$1.3M
South Central Clinics, Inc.	MS	Obstetrics & Gynecology Physician	$0	$1.3M
Wassim Mouannes	MS	Cardiovascular Disease Physician	$348K	$0
Gulshan Oberoi	MS	Neurology Physician	$344.5K	$0
Herbert Rogers	MS	Internal Medicine Physician	$242.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Petal Urgent Care LLC	MS	Urgent Care Clinic/Center	$0	$1.9M
Ted Harden	MS	Optometrist	$93.5K	$293.3K
Judd Reynolds	MS	Family Medicine Physician	$284.4K	$0
Angel Johnson	MS	Family Medicine Physician	$109.7K	$0
Geralynn Morrison	MS	Internal Medicine Physician	$94.4K	$0
George Gillespie	MS	Family Medicine Physician	$70.3K	$0
Hang Nguyen	MS	Family Nurse Practitioner	$38.6K	$0
Ronald Bullock	MS	Family Medicine Physician	$37.5K	$0

David Roy — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References