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

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

Stephen Henry (NPI 1811925183)

Field	Value
Entity Type	Individual
Organization	Stephen Henry
Address	2319 E Washington Blvd
City	Pasadena
State	CA
ZIP	91104
Taxonomy	Geriatric Medicine (Internal Medicine) Physician
NPI Enumerated	June 28, 2006

Payer Source	Total Paid
Medicare	$797.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

52 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…	1,870	$110	$198.6K
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…	750	$150	$108.9K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	2,080	$50	$103.8K
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…	1,170	$70	$85.1K
J1306	Injection, inclisiran, 1 mg	6,530	$10	$58.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,500	$20	$33K
J0897	Injection, denosumab, 1 mg	1,740	$20	$31.3K
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…	2,460	$10	$29.5K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	250	$70	$17.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	2,040	$10	$16.3K

Showing 1–10 of 52

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 52 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Stephen Henry — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

52 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1306	45	60	9,660	$10	$149K
J0897	712	1,030	3,060	$20	$91.4K
99233	8,410	11,530	120	$100	$26.2K
99214	339	37,970	120	$90	$23.2K
85025	1,036	1,210	150	$10	$17.2K
17110	1,644	1,840	110	$90	$17K
99232	11,845	12,280	90	$70	$16.3K
99215	212	15,360	50	$130	$14.4K
99213	776	34,660	80	$70	$13.2K
17000	1,869	2,270	150	$40	$11.4K

Showing 1–10 of 52

Stephen Henry — Billing Profile & Reimbursement Data

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Stephen Henry — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References