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.

Karen Nielsen (NPI 1902980816)

Field	Value
Entity Type	Individual
Organization	Karen Nielsen
Address	2100 Erwin Rd
City	Durham
State	NC
ZIP	27710
Taxonomy	Anesthesiology Physician
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicare	$16K
Medicaid	$0

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
01610	The provider performs anesthesia services for a patient undergoing any procedure of the nerves, muscles, tendons, fascia, and bursae of the shoulder and axilla.	30	$160	$4.2K
00400	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified.	50	$80	$3.5K
01480	The provider performs anesthesia services for a patient undergoing an open procedure on the bones of the lower leg, ankle, and foot.	20	$150	$2.2K
00300	The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system, muscles and nerves of head, neck, and posterior trunk.	20	$80	$1.9K
00320	The provider performs anesthesia services for a patient undergoing any procedure on the esophagus, thyroid, larynx, trachea and lymphatic system of the neck when the patient is one year or older.	10	$120	$1.6K
00918	The provider performs anesthesia services for a patient undergoing fragmentation, manipulation, and/or removal of a ureteral calculus. The surgical provider accesses the ureter through the urethra,…	10	$90	$1K
00902	The provider performs anesthesia services for a procedure involving the anus or rectum.	10	$80	$870
00910	The provider performs anesthesia services for a patient undergoing transurethral procedures including urethrocystoscopy. The surgical provider may examine the organs of the urinary system from within…	10	$60	$680

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Karen Nielsen — 1 of 8 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

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
01610	3	10	10	$110	$1.9K
00320	30	60	10	$110	$1.6K
00902	31	40	10	$70	$1.6K
00300	5	70	10	$90	$1.5K
00918	44	70	10	$80	$1.3K
01480	81	190	10	$70	$1.3K
00400	3	150	10	$70	$1K
00910	159	220	10	$60	$1K

Karen Nielsen — 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