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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Mark Smith (NPI 1881676047)

Field	Value
Entity Type	Individual
Organization	Mark Smith
Address	1219 Lexington Ave
City	Thomasville
State	NC
ZIP	27360
Taxonomy	Surgery Physician
NPI Enumerated	November 15, 2005

Payer Source	Total Paid
Medicare	$40.2K
Medicaid	$0

Medicare: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	130	$60	$7.7K
47563	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease. She injects dye and…	10	$540	$6.5K
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…	60	$90	$5.1K
45384	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions using hot biopsy…	30	$170	$4.9K
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	$120	$3.3K
99203	The provider sees a new 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 provider…	40	$80	$3.3K
G0121	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	20	$170	$3.3K
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…	20	$130	$2.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$70	$1.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	30	$40	$1.3K

Showing 1–10 of 11

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Mark Smith — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

11 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	12,741	18,060	110	$80	$15.1K
43239	455	560	60	$120	$11K
G0121	134	260	20	$280	$8.1K
99213	4,948	16,320	70	$50	$7.1K
47563	13	20	20	$450	$6.8K
99223	3,489	4,580	30	$130	$6.5K
45384	10	20	20	$170	$5.4K
99204	4,523	8,430	30	$110	$4.8K
99203	1,814	5,450	30	$70	$3.1K
99231	711	1,500	30	$40	$2.1K

Showing 1–10 of 11

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomasville-archdale Pediatrics, PLLC	NC	Pediatrics Physician	$0	$41.8M
Novant Health Thomasville Medical Center, LLC	NC	General Acute Care Hospital	$0	$15.3M
Usman Khawaja	NC	Interventional Cardiology Physician	$119.3K	$0
Raschid Ghoorahoo	NC	Nurse Practitioner	$21.2K	$0

Mark Smith — Billing Profile & Reimbursement Data

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Mark Smith — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References