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

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

James Pride (NPI 1831138528)

Field	Value
Entity Type	Individual
Organization	James Pride
Address	3405 N Arlington Heights Rd
City	Arlington Heights
State	IL
ZIP	60004
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 6, 2006

Payer Source	Total Paid
Medicare	$229.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

25 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…	850	$90	$79.6K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	300	$140	$41.6K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	130	$280	$35.9K
G0446	Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes	250	$30	$6.9K
90694	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…	90	$80	$6.8K
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…	100	$60	$5.4K
0241U	N/A	40	$140	$5.2K
G0444	Annual depression screening, 5 to 15 minutes	240	$20	$4.5K
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…	30	$130	$4.1K
G0009	Administration of pneumococcal vaccine	130	$30	$4K

Showing 1–10 of 25

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 25 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Illinois Distribution

James Pride — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. state median

25 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	842	930	230	$70	$21.8K
91320	735	940	90	$130	$17.2K
99214	508	18,540	110	$80	$17.1K
G0439	211	4,030	70	$130	$13.6K
99215	3,755	6,240	40	$120	$10.1K
99213	7,320	17,390	70	$60	$8.8K
90677	21	2,540	20	$270	$8K
90694	611	1,830	60	$70	$6.5K
90480	1,326	1,570	130	$40	$5.9K
99496	330	560	20	$210	$5.5K

Showing 1–10 of 25

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jason Thalheimer	IL	Internal Medicine Physician	$289.8K	$0
Diane Flershem	IL	Internal Medicine Physician	$273.6K	$0
Murray Propes	IL	Internal Medicine Physician	$154.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Access Community Health Network	IL	Federally Qualified Health Center (FQHC)	$0	$9.3M
Alexian Brothers Center For Mental Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.8M
Hearing Screening Associates LLC	IL	Audiologist	$0	$4.4M
Northwest Home Care, Inc.	IL	Home Health Agency	$0	$4.2M
Cook County	IL	Primary Care Clinic/Center	$0	$3.8M
Family Medical Supplies, Inc	IL	Durable Medical Equipment & Medical Supplies	$0	$3.1M
Omar Hassan	IL	Ophthalmology Physician	$1.1M	$0
Michaela Klein	IL	Surgery Physician	$944.5K	$0
Jimmy Varghese	IL	Rheumatology Physician	$632.9K	$12.9K
Adam Prickett	IL	Ophthalmology Physician	$538.2K	$0

James Pride — Billing Profile & Reimbursement Data

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James Pride — 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