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

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

Mel Setter (NPI 1922022581)

Field	Value
Entity Type	Individual
Organization	Mel Setter
Address	920 Sw Lane St
City	Topeka
State	KS
ZIP	66606
Taxonomy	Physician Assistant
NPI Enumerated	July 27, 2006

Payer Source	Total Paid
Medicare	$65.8K
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
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…	870	$50	$42K
69433	The provider makes a small opening in the eardrum and inserts a ventilating tube under local or topical anesthesia.	60	$130	$7.6K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	60	$110	$6.8K
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,…	220	$30	$6K
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…	20	$70	$1.3K
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…	20	$60	$960
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$40	$630
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	30	$10	$200

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. Kansas Distribution

Mel Setter — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	4,124	4,310	120	$70	$16.4K
31231	29	60	50	$120	$10.6K
99213	87	4,330	90	$50	$8.7K
95117	45	50	330	$10	$4K
99203	990	1,450	30	$60	$3.6K
69433	1	30	20	$150	$3.3K
99212	42	1,050	30	$30	$2.1K
99202	134	200	20	$40	$1.5K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hays Medical Center, Inc.	KS	Rural Health Clinic/Center	$0	$2.3M
Don Wynn	TX	Pulmonary Disease Physician	$1.4M	$0
Topeka Ear, Nose And Throat, P.A.	KS	Otolaryngology Physician	$0	$1.3M
Jay Robinow	KS	Radiation Oncology Physician	$1.2M	$0
Hays Medical Center, Inc.	KS	Internal Medicine Physician	$0	$1.1M
Uma Guniganti	OK	Cardiovascular Disease Physician	$797.5K	$0
Hays Medical Center Inc	KS	General Acute Care Hospital	$0	$595.8K
Matthew Mallory	AR	Radiation Oncology Physician	$570.4K	$0
Surekha Boddipalli	IL	Hematology & Oncology Physician	$430.7K	$0
Roy Bryan	CA	Diagnostic Radiology Physician	$417.1K	$90

Mel Setter — Billing Profile & Reimbursement Data

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Mel Setter — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References