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

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

Clay Shearer (NPI 1881601961)

Field	Value
Entity Type	Individual
Organization	Clay Shearer
Address	10060 Demia Way
City	Florence
State	KY
ZIP	41042
Taxonomy	Dermatology Physician
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicare	$934.8K
Medicaid	$0

Key Findings

This provider’s billing footprint is effectively single‑payer: lifetime Medicare revenue is $934.8K and there is no Medicaid billing on file. The absence of any Medicaid claims on record means analyses of in‑state Medicaid share or dual‑payer mix are not possible and the practice appears to rely predominantly on Medicare revenue.

Revenue is highly concentrated in a few procedure codes: the precomputed top‑3 Medicare codes account for 43.7% of total Medicare revenue, with 17004 contributing $206.2K (23.1%), 13132 contributing $97.2K (10.9%), and 99214 contributing $86.8K (9.7%). This concentration signals that a relatively small set of interventions drive nearly half of the Medicare dollars attributed to this NPI.

The code mix indicates a surgical dermatology practice with substantial procedural throughput: high‑revenue codes include lesion destruction (17004, 17003, 17000, 17110), excisions of malignant lesions (11603, 11642, 11643, 11622), complex wound repairs (13132, 13121, 13101), and a steady volume of biopsies/shave procedures (11102, 11301, 11302). High counts for both procedure codes and evaluation & management codes (99214, 99213) suggest the practice combines operative dermatologic procedures with ongoing office‑based patient management.

Several of the provider’s top procedural codes are national outliers, indicating an unusually large procedural volume relative to peers. For example, 17004 ranks #9 of 9638 providers nationally (100th percentile) and is flagged as an "extreme outlier, far above typical national volume for this code," while 13121 ranks #37 of 3302 (99th percentile) and 11603 ranks #8 of 3144 (100th percentile), both also characterized as extreme outliers. These rank positions point to national‑scale specialization in lesion destruction and excisional procedures.

Complex closure and reconstruction codes further underscore a high procedural intensity: 13132 generates $97.2K (10.9% of Medicare revenue) and ranks #113 of 3088 providers nationally (96th percentile; "notably above typical national volume for this code"). Additional complex repair codes such as 13101 and 13152 appear with notable revenue and above‑typical ranks, reinforcing a service line emphasis on more complex laceration/wound repairs.

The provider also reports very high office visit volumes for established patients, which supports continuity of care around procedural services. 99214 accounts for $86.8K (9.7% of Medicare revenue) and ranks #9629 of 479517 providers nationally (98th percentile; "extreme outlier, far above typical national volume for this code"), while 99213 contributes $69.8K (7.8%) and is cited as an extreme outlier at the 99th percentile. This combination of high E/M and procedural volumes suggests integrated pre‑ and post‑op management for a procedural dermatology practice.

Biopsy and lesion sampling are material revenue contributors and also show above‑peer volume: 11102 accounts for $54.4K (6.1% of Medicare revenue) and ranks #266 of 18797 providers nationally (99th percentile; "extreme outlier, far above typical national volume for this code"). Multiple shave and biopsy codes (11301, 11302, 11103) appear among the top revenue drivers, indicating routine diagnostic work that likely feeds the practice’s excision and destruction caseloads.

This NPI has a long tenure: enumerated on 2006-08-02 (~20 years ago), which may reflect an established referral base and operational stability. Combined with the concentrated Medicare revenue and lack of Medicaid billing, the profile suggests a mature, Medicare‑focused dermatology practice with nationally high procedural volumes in lesion destruction, excision, and complex repairs—information that payers and competitors should weigh when assessing network negotiations, capacity, and local market positioning.

Medicare: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17004	The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others.	1,950	$110	$206.2K
13132	The provider repairs a wound measuring 2.6 cm to 7.5 cm in size of the cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet, which may require scar revision, debridement extensive…	290	$330	$97.2K
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…	1,070	$80	$86.8K
13121	This is for a complex repair of a wound to the scalp, arms, and/or legs. This wound should be 2.6 to 7.5 cm in size.	290	$290	$82.1K
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…	1,320	$50	$69.8K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	880	$60	$54.4K
11301	The provider shaves off a single epidermal or dermal lesion of 0.6 to 1.0 cm in diameter from the skin of the trunk, arms, or legs.	650	$70	$42.9K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	910	$30	$30.1K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	440	$70	$28.3K
13101	This is for a complex repair of a wound to the trunk. This wound should be 2.6 to 7.5 cm in size.	110	$240	$25.3K

Showing 1–10 of 44

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 44 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Clay Shearer — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

44 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
13132	2	40	80	$200	$20K
11312	7	10	60	$60	$16.9K
99214	79	7,230	110	$70	$14.1K
13121	2	40	30	$230	$13.7K
11102	5	230	120	$60	$9.6K
17000	8	270	210	$30	$8.9K
13101	2	20	20	$260	$8.5K
17004	1	120	30	$110	$8.4K
17110	3	260	100	$60	$8.4K
99213	28	7,250	80	$50	$7.7K

Showing 1–10 of 44

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Shearer	KY	Dermatology Physician	$267.9K	$0
Rebecca Short	OH	Dermatology Physician	$162K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Personal Touch Home Care Of Ky, Inc.	KY	Home Health Agency	$0	$127.2M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$65.5M
Northern Kentucky Consumer Directed Options Program	KY	Supports Brokerage Agency	$0	$52.8M
Healthy Adult Day Healthcare, LLC	KY	Adult Day Care Clinic/Center	$0	$37.7M
Dungarvin Kentucky, LLC - Florence	KY	Developmentally Disabled Services Day Training Agency	$0	$35.3M
Northern Kentucky Consumer Directed Option Program	KY	Supports Brokerage Agency	$0	$27.5M
Personal Touch Home Care Of Ky, Inc.	KY	Home Health Agency	$0	$13.2M
Tri-generations, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$11.2M
Bawac, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$5.5M
Advanced Technology Of Kentucky Inc.	KY	Oxygen Equipment & Supplies (DME)	$0	$5.1M

Clay Shearer — Billing Profile & Reimbursement Data

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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