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

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

Adam Procunier (NPI 1912410374)

Adam Procunier is a family nurse practitioner provider located in Orlando, Florida. This profile covers 11 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Adam Procunier
Address	1812 N Mills Ave
City	Orlando
State	FL
ZIP	32803
Taxonomy	Family Nurse Practitioner
NPI Enumerated	November 8, 2017

Payer Source	Total Paid
Medicare	$34.3K
Medicaid	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	190	$70	$14K
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…	100	$50	$5.4K
54200	The provider injects a medication into the external area of the penis. He performs this procedure to treat a disease known as Peyronie disease in which there occurs an abnormal curvature of the erect…	80	$70	$5.3K
52000	In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…	20	$140	$2.4K
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	$80	$2.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$110	$1.9K
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,…	60	$30	$1.8K
54235	The provider injects pharmacologic agents such as papaverine, phentolamine, or prostaglandin E1 into the corpora cavernosa of the penis. He performs this procedure to treat patients with erectile…	10	$60	$840
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	40	$10	$280
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	10	$10	$140

Showing 1–10 of 11

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	13,555	32,760	140	$90	$25K
52000	625	670	80	$160	$17.4K
99213	13,172	30,010	80	$60	$12K
99215	6,802	8,550	40	$130	$10.7K
99204	12,482	19,040	40	$110	$7K
54200	1	10	60	$80	$4.4K
99212	2,330	6,920	40	$40	$2.9K
51798	588	740	120	$10	$2K
54235	26	30	20	$70	$1.6K
99211	1,588	1,700	50	$20	$1.5K

Adam Procunier — Billing Profile & Reimbursement Data

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Adam Procunier — 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