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

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

Shoua Nelson (NPI 1912489360)

Field	Value
Entity Type	Individual
Organization	Shoua Nelson
Address	3400 Union Ave
City	Sheboygan
State	WI
ZIP	53081
Taxonomy	Nurse Practitioner
NPI Enumerated	September 2, 2018

Payer Source	Total Paid
Medicare	$27.1K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	150	$110	$16.8K
G0316	Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date…	310	$20	$6.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	$80	$2.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	$50	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Shoua Nelson — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	1,372	2,110	60	$90	$8.7K
99232	2,793	3,490	60	$60	$7.2K
99223	78	2,080	30	$130	$6.1K
G0316	4	90	50	$20	$1.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vista Care South Dakota, LLC	WI	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20M
Sheboygan County Health & Human Services	WI	Community/Behavioral Health Agency	$0	$19.3M
Lakeshore Community Health Care, Inc	WI	Federally Qualified Health Center (FQHC)	$0	$14.7M
Aurora Health Care Central, Inc.	WI	General Acute Care Hospital	$0	$12.4M
Universal Home Health Care, Inc	WI	Home Health Agency	$0	$11.6M
St. Nicholas Hospital-sisters Of The Third Order Of St Francis	WI	General Acute Care Hospital	$0	$5M
Sheboygan County Health & Human Services	WI	Case Management Agency	$0	$4.1M
Sheboygan Area School District	WI	Local Education Agency (LEA)	$0	$3.9M
William Shows	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.9M
Hospice Advantage, LLC	WI	Community Based Hospice Care Agency	$0	$3.6M

Shoua Nelson — Billing Profile & Reimbursement Data

Sign up for Shoua Nelson — Billing Profile & Reimbursement Data policy alerts

Shoua Nelson — Billing Profile & Reimbursement Data

Sign up for Shoua Nelson — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References