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

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

Karen Rodriguez (NPI 1861887929)

Field	Value
Entity Type	Individual
Organization	Karen Rodriguez
Address	55 Fruit St
City	Boston
State	MA
ZIP	02114
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	April 5, 2015

Payer Source	Total Paid
Medicare	$115.1K
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
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	650	$70	$42.1K
71250	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material.	550	$70	$36K
71271	The provider performs a low–dose computed tomography (LDCT), with low–dose ionizing radiation, for examination of the thorax without using contrast material to screen for lung cancer.	120	$100	$11.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	1,070	$10	$7.5K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	110	$70	$7.3K
32408	In this procedure, the provider removes a core tissue sample from a lung or the mediastinum to diagnose conditions such as lung or mediastinal cancer. The code includes imaging guidance, when…	40	$120	$4.3K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	480	$10	$4.3K
99152	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or…	40	$10	$360
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	6,940	$0	$0

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. Massachusetts Distribution

Karen Rodriguez — 2 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
71260	17	550	60	$50	$6K
71250	20	590	70	$50	$5.9K
71275	116	530	60	$70	$5.3K
71271	31	300	40	$70	$4.3K
71045	56	620	300	$10	$3.6K
71046	148	1,040	90	$10	$2.3K
32408	3	40	20	$120	$2.3K
Q9967	78	200	4,840	$1	$1.2K
99152	304	460	60	$10	$790

Karen Rodriguez — Billing Profile & Reimbursement Data

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Karen Rodriguez — 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