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

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

Anand Jain (NPI 1831489616)

Anand Jain is a gastroenterology physician provider located in Atlanta, Georgia. This profile covers 12 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Anand Jain
Address	1365 Clifton Rd Ne Bldg B
City	Atlanta
State	GA
ZIP	30322
Taxonomy	Gastroenterology Physician
NPI Enumerated	April 13, 2011

Payer Source	Total Paid
Medicare	$30.7K
Medicaid	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
91010	The provider uses a manometer to analyze esophageal muscle pressure and movement in a patient with gastroesophageal reflux disease or GERD. He interprets the findings and prepares a report.	50	$170	$8.3K
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…	40	$90	$3.5K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	40	$90	$3.2K
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…	20	$140	$3.1K
91037	The provider performs gastroesphageal reflux test to determine the backflow of acid from the stomach into the esophagus with nasal catheter intraluminal impedance electrode placement. He records and…	20	$130	$2.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$80	$2.2K
99204	The provider sees a new 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 provider…	20	$120	$2.2K
91040	The provider performs esophageal balloon dilation to determine whether the patient’s chest pain results from esophageal or cardiac causes. The procedure includes provocation, if performed.…	50	$40	$1.7K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	20	$60	$1.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10	$100	$1.1K

Showing 1–10 of 12

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	10,739	13,640	120	$80	$17.8K
43239	400	490	70	$120	$11.9K
99215	2,183	3,270	30	$120	$7.7K
99204	5,238	7,260	30	$110	$5.1K
99222	2,944	3,080	30	$100	$3.9K
43235	43	210	20	$110	$2.9K
91035	8	10	20	$110	$2.6K
99212	2,087	2,720	30	$40	$2.1K
91010	4	20	20	$60	$1.9K
99221	210	560	20	$60	$1.6K

Anand Jain — Billing Profile & Reimbursement Data

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Anand Jain — 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