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.

Philip Clapham (NPI 1861806580)

Field	Value
Entity Type	Individual
Organization	Philip Clapham
Address	1740 W Taylor St
City	Chicago
State	IL
ZIP	60612
Taxonomy	Infectious Disease Physician
NPI Enumerated	June 20, 2014

Payer Source	Total Paid
Medicare	$16.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	70	$80	$5.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	50	$120	$5.8K
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…	40	$60	$2.5K
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…	20	$100	$2.4K
99451	A consulting physician or other qualified healthcare professional performs a 5–minute or more consult via telephone, internet, or electronic health record (EHR) and provides a written report to the…	10	$20	$260

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Illinois Distribution

Philip Clapham — 0 of 5 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

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	3,554	5,990	100	$100	$18.7K
99214	14,251	18,540	110	$80	$17.1K
99223	2,987	6,190	50	$140	$10.4K
99215	4,326	6,240	40	$120	$10.1K
99451	7	10	20	$30	$790

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lida Mina	AZ	Hematology & Oncology Physician	$1.3M	$0
Anton Cabellon	IN	Nephrology Physician	$1.1M	$0
Costantine Albany	IN	Medical Oncology Physician	$1M	$0
Noah Hahn	MD	Hematology & Oncology Physician	$712K	$0
Anne Greist	IN	Hematology & Oncology Physician	$423.3K	$0
Irmina Gradus-pizlo	CA	Cardiovascular Disease Physician	$108.2K	$153.3K
Douglas Rex	IN	Gastroenterology Physician	$177.9K	$0
Antonio Navarrete Casas	IN	Cardiovascular Disease Physician	$150.7K	$0
Michael Byers	IN	Cardiovascular Disease Physician	$145.2K	$0
William Gill	IN	Cardiovascular Disease Physician	$135.7K	$0

Philip Clapham — Billing Profile & Reimbursement Data

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Philip Clapham — 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

Frequently Asked Questions

References