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

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

Howard Nelson (NPI 1811067952)

Field	Value
Entity Type	Individual
Organization	Howard Nelson
Address	1144 Opal Court
City	Hagerstown
State	MD
ZIP	21740
Taxonomy	Oral and Maxillofacial Surgery (Dentist)
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicare	$9.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	140	$50	$6.4K
40808	The provider performs a biopsy, a surgical procedure in which the provider excises a sample of the tissues from the vestibule of a patient’s mouth. He commonly performs this procedure to diagnose an…	20	$130	$2.3K
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…	20	$60	$1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maryland Distribution

Howard Nelson — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	8,595	9,280	100	$60	$12.5K
40808	1	10	20	$120	$2K
99202	11	570	20	$50	$1.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Oral & Maxillofacial Surgeons, PC	WV	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr. David M. Vieth 2, P.C.	MD	General Practice Dentistry	$0	$77.8M
Potomac Case Management Services, Inc.	MD	Case Management Agency	$0	$28M
Phoenix Health Center LLC	MD	Methadone Clinic	$507.7K	$21.4M
Awakenings Recovery Center, LLC	MD	Substance Abuse Rehabilitation Facility	$0	$19.8M
Qualitycare Internet, LLP	MD	Mental Health Counselor	$0	$19.4M
Walnut Street Community Health Center, Inc.	MD	Federally Qualified Health Center (FQHC)	$0	$19.3M
Board Of Education Of Washington County	MD	Local Education Agency (LEA)	$0	$19.1M
Center For Pain Management, LLC	MD	Interventional Pain Medicine Physician	$0	$18.9M
Metro Treatment Of Maryland LP	MD	Community/Behavioral Health Agency	$361K	$16.6M
The Western Maryland Counseling Center	MD	Community/Behavioral Health Agency	$0	$16.5M

Howard Nelson — Billing Profile & Reimbursement Data

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Howard 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

Nearby Providers

Frequently Asked Questions

References