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

Why is the Medicaid comparison limited to New York 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. New York (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.

Justin Douglas (NPI 1841820099)

Field	Value
Entity Type	Individual
Organization	Justin Douglas
Address	45 Foster Rd
City	Hopewell Junction
State	NY
ZIP	12533
Taxonomy	Family Nurse Practitioner
NPI Enumerated	January 16, 2020

Payer Source	Total Paid
Medicare	$30.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	140	$70	$9.8K
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…	150	$60	$9.3K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	40	$100	$3.6K
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…	30	$90	$2.9K
99441	N/A	60	$40	$2K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	40	$20	$870
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	20	$40	$670
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…	10	$40	$560
17250	The provider cauterizes granulation tissue using chemicals like silver nitrate or potassium hydroxide to heal the injured tissue.	20	$20	$430

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New York Distribution

Justin Douglas — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99308	79	2,360	250	$60	$44.9K
99309	76	2,150	220	$90	$41.7K
99214	942	30,450	90	$100	$19K
99310	66	580	50	$120	$12.6K
99213	2,338	31,440	80	$70	$12.1K
97597	25	460	50	$80	$7.5K
17250	5	100	40	$60	$6.8K
99204	527	14,170	30	$130	$6.6K
99441	23	1,240	30	$40	$2.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Mexico Pac Services PC	NM	Hospitalist Physician	$0	$3.2M
Jeffrey Lieberman	FL	Diagnostic Radiology Physician	$1.4M	$0
Michael Shriver	OH	Diagnostic Radiology Physician	$1.1M	$0
Stephen Pomeranz	OH	Diagnostic Radiology Physician	$642.3K	$0
Daniel Zakhary	NY	Cardiovascular Disease Physician	$445K	$133.2K
Michael Pereira	NJ	Radiation Oncology Physician	$559.6K	$0
William Field	NY	Anatomic Pathology & Clinical Pathology Physician	$514.4K	$0
Nirav Shah	NY	Cardiovascular Disease Physician	$372.6K	$69.7K
Scott Kahn	NY	Urology Physician	$410.9K	$10.3K
Mehul Patel	NY	Cardiovascular Disease Physician	$345.1K	$60.1K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Subhash Kulkarni	NY	Internal Medicine Physician	$115K	$0
Vincent Bosco	NY	Physician Assistant	$31.9K	$0
Sidhant Sehrawat	NY	Family Nurse Practitioner	$23.8K	$0

Justin Douglas — Billing Profile & Reimbursement Data

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Justin Douglas — 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