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.

Philana Cunningham (NPI 1861093601)

Field	Value
Entity Type	Individual
Organization	Philana Cunningham
Address	1345 Park St # 111
City	Paso Robles
State	CA
ZIP	93446
Taxonomy	Family Nurse Practitioner
NPI Enumerated	November 6, 2020

Payer Source	Total Paid
Medicare	$6.9M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant payer activity on file: total Medicare revenue is listed as $6.9M while there is no Medicaid billing on file, so the provider is effectively single-payer (Medicare) in the dataset. The absence of any Medicaid claims means state-plan comparisons or in-state Medicaid market positioning cannot be assessed from these records.

Revenue is extremely concentrated: the precomputed summary shows the top 3 Medicare codes by revenue account for 100.0% of this provider's total Medicare revenue, and the single listed code K1034 is reported as 100.0% of Medicare revenue. That concentration indicates the provider’s Medicare business is effectively driven by a narrow set of services rather than a broad primary-care or procedure mix.

The top-performing code is K1034, described as provision of covid-19 test, nonprescription self-administered and self-collected use. That line is reported at 584.8K claims with a $12 avg paid/claim and $7M revenue, which frames this operation as high-volume distribution or provisioning of self-test kits rather than low-volume, high-acuity clinical encounters. Analysts should interpret the code mix as reflecting a service-line oriented to mass testing kit provision rather than typical Family Nurse Practitioner face-to-face E/M throughput.

Unit economics and volume signal a low-price, high-throughput model: K1034’s 584.8K claims at $12 avg paid/claim generate the bulk of reported revenue. This pattern is consistent with retail-style dispensing or centralized distribution of pandemic-era diagnostic products and suggests margins and contract negotiation dynamics will differ from typical clinical services.

On national competitiveness for the listed code, the provider ranks #71 of 30143 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code). That ranking characterizes the provider as a national-scale outlier for K1034 volume and shows it is a major participant for this specific service relative to peers.

The provider’s taxonomy is Family Nurse Practitioner and the NPI was enumerated 2020-11-06 (~6 years ago), indicating relatively recent enrollment in federal billing yet rapid scaling in the single reported service line. The combination of recent enumeration and very high K1034 volume suggests the practice or business model quickly focused on pandemic-related test provision after enrollment.

Because reporting is dominated by one pandemic-era code and there is no Medicaid activity, caution is warranted when inferring broader clinical capacity or typical primary-care volumes from these claims. Comparative analyses of continuity-of-care, chronic disease management, or other FNP-typical services are not supported by the available Medicare/Medicaid billing mix and will require supplemental data sources.

For payer operational implications, this profile reads more like a vendor-oriented or high-throughput dispensing relationship than a traditional ambulatory provider relationship: payers evaluating network inclusion, prior-authorization exceptions, or audit priorities should treat K1034-related flows as a distinct service-line with unusually high claim counts and a national outlier status. Contracting and utilization-management approaches that assume routine E/M patterns are unlikely to fit this provider’s observed Medicare activity.

Medicare: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
K1034	Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count	584,800	$10	$7M

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Philana Cunningham — 1 of 1 code 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

1 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
K1034	8	2,780	710	$10	$58.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Merry Taheri	CA	Family Nurse Practitioner	$12.1M	$0
Mayra Flores	CA	Nurse Practitioner	$6M	$0
Laura Purdy	CA	Family Medicine Physician	$3.7M	$7.4K
Katan Patel	TX	Emergency Medicine Physician	$1.3M	$0
Lauren Petasne	CO	Family Nurse Practitioner	$1.3M	$0
Assad Sattar	MI	Interventional Cardiology Physician	$630.3K	$0
William Martin	TX	Family Medicine Physician	$481K	$0
Wesley Nahm	TX	Emergency Medicine Physician	$344K	$10.6K
Sarena Sloot	WA	Nurse Practitioner	$307.9K	$0
Ravi Patel	FL	Family Medicine Physician	$230.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chelsea Stevens	CA	Occupational Therapist	$166.5K	$0
Christina Veras	CA	Physical Therapist	$39K	$0
Michelina Timenovich	CA	Optometrist	$21.2K	$0

Philana Cunningham — Billing Profile & Reimbursement Data

Sign up for Philana Cunningham — Billing Profile & Reimbursement Data policy alerts

Philana Cunningham — Billing Profile & Reimbursement Data

Sign up for Philana Cunningham — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References