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.

Pamela Harston (NPI 1902973043)

Field	Value
Entity Type	Individual
Organization	Pamela Harston
Address	1890 Lyda Ave
City	Bowling Green
State	KY
ZIP	42104
Taxonomy	Physical Medicine & Rehabilitation Physician
NPI Enumerated	November 30, 2006

Payer Source	Total Paid
Medicare	$1.8M
Medicaid	$0

Key Findings

This provider’s Medicare activity is highly concentrated in procedures and injectables used for joint interventions and imaging support: J7320 (hyaluronan), 77002 (fluoroscopic guidance), and 20610 (joint/bursa aspiration/injection) together account for 72.6% of total Medicare revenue, indicating a practice focused on image-guided musculoskeletal injections and procedural care rather than broad primary-care E/M volume. The CPT mix (multiple intra-articular hyaluronan products and large-volume imaging guidance) points to a service line oriented toward therapeutic joint injections and image-guided procedural throughput.

Revenue concentration is extreme: the top three Medicare codes drive the bulk of lifetime Medicare revenue (precomputed at 72.6%), with J7320 alone representing $503.8K (29.5% of Medicare revenue), 77002 at $443K (26.0%), and 20610 at $293.1K (17.2%). This concentration suggests that changes in utilization, reimbursement, or supplier access for these specific codes would have outsized impact on the provider’s Medicare revenue.

Payer mix is effectively single-payer: lifetime Medicare revenue is $1.8M while there is no Medicaid billing on file. The absence of any Medicaid claims positions this clinician as a Medicare-focused biller and suggests limited or no participation in Medicaid business lines in available records.

Competitive standing for several high-revenue codes is unusually prominent nationally. The provider ranks #6 of 462 for J7320 (99th percentile, described as an extreme outlier), #4 of 7010 for 77002 (100th percentile, extreme outlier), and #4 of 39752 for 20610 (100th percentile, extreme outlier). Those rankings indicate the provider is a major national volume outlier for key procedure codes tied to its business model, far above typical peer volumes.

Several additional supply codes also appear as outliers in national rank, reinforcing a procedure-centered operation: Q9965 ranks #1 of 299 (100th percentile, extreme outlier) with $197.6K revenue and J7324 ranks #19 of 1509 (99th percentile, extreme outlier) with $72.9K. These high ranks for contrast material and multiple hyaluronan products suggest heavy procedural throughput and repeated intra-articular services rather than a focus on time-based evaluation-and-management encounters.

At the same time, the provider bills some office and chronic care management codes (for example 99212, 99202, 99426, and 99490), but those codes are small contributors to Medicare revenue (each under 1.0% of total) and, where present, either rank as typical volumes or are described as extreme outliers in count depending on the code. This pattern indicates that office E/M and care-management services are supplementary to a dominant procedural practice.

The provider has long tenure in the NPI file, with enumeration dated 2006-11-30 (~20 years ago), which supports that the observed high volumes reflect an established, ongoing practice rather than a short-term spike. Longevity combined with the concentrated procedural mix implies an intentional service-line focus maintained over many years.

Multiple billed items show extreme or notable outlier status for volume while contributing little paid dollars per claim (for example Q9965 reported at 197.6K claims, $1 avg paid/claim, $197.6K revenue and Q9966 and J1885 with very high claim counts but $0 average paid/claim reported). These patterns highlight a high-frequency use of low-unit-cost supply items and contrast agents alongside higher-paid procedural codes, consistent with an image-guided musculoskeletal injection practice that files both supply and procedure lines.

Medicare: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J7320	Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg	100,750	$10	$503.8K
77002	The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…	5,400	$80	$443K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	5,430	$50	$293.1K
Q9965	Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml	197,580	$1	$197.6K
J3304	Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg	6,530	$10	$84.9K
J7324	Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose	780	$90	$72.8K
J7323	Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	340	$100	$33.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	480	$40	$17.6K
99426	Clinical staff members, directed by a physician or other qualified healthcare professional, perform management and care plan services for a patient with a complex chronic condition, expected to last…	380	$50	$17.3K
J7325	Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg	2,110	$10	$14.8K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

Pamela Harston — 9 of 16 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

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J7320	1	10	6,550	$10	$168.1K
J3304	1	30	1,570	$10	$29.3K
Q9965	1	10	130	$1	$27K
J7325	10	30	1,630	$10	$15.3K
J7324	1	30	70	$100	$13.4K
99490	143	290	170	$30	$11.9K
99426	3	10	180	$50	$11.3K
77002	1	120	40	$70	$10.1K
J7323	1	10	60	$100	$9.6K
20610	1	640	80	$40	$6.6K

Showing 1–10 of 18

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Jason Fogg	KY	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$1.2M	$0
Keerthi Prasad	TX	Vascular & Interventional Radiology Physician	$666.7K	$0
James Farrage	KY	Physical Medicine & Rehabilitation Physician	$182.9K	$239K
Bryan Glaenzer	KY	Vascular & Interventional Radiology Physician	$329.4K	$520
John Rush	TX	Emergency Medicine Physician	$252.8K	$0
Robert Boyer	KY	Occupational Medicine Physician	$200.2K	$0
Mamdouh Khayat	OH	Vascular & Interventional Radiology Physician	$184.8K	$0
Sergei Sobolevsky	NY	Vascular & Interventional Radiology Physician	$33.9K	$2.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greenview Hospital, Inc.	KY	General Acute Care Hospital	$0	$49.1M
Advantage Health Club	KY	Adult Day Care Clinic/Center	$0	$20.6M
Faith Harbor	KY	Developmentally Disabled Services Day Training Agency	$0	$20.1M
Marpe' Therapy Services	KY	Mental Health Counselor	$0	$11.5M
Positive Directions Support Services, PLLC	KY	Community/Behavioral Health Agency	$0	$9.9M
Dungarvin Kentucky, LLC - Bowling Green	KY	Developmentally Disabled Services Day Training Agency	$0	$8.1M
Destiny Adult, Child & Family Services LLC	KY	Community/Behavioral Health Agency	$0	$7.1M
Familyworks Therapy, LLC	KY	Community/Behavioral Health Agency	$0	$7M
Zipclinic, Psc	KY	Primary Care Clinic/Center	$0	$4.4M
Ky Doctors Of Optometry, PLLC	KY	Eyewear Supplier	$0	$4.3M

Pamela Harston — 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