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

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

Sansum Clinic (NPI 1932121514)

Sansum Clinic is a multi-specialty clinic/center provider located in Santa Barbara, California. This profile covers 0 Medicare and 196 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Sansum Clinic
Address	317 W Pueblo St
City	Santa Barbara
State	CA
ZIP	93105
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 24, 2006

Payer Source	Total Paid
Medicaid	$24.4M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

196 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…	54,310	$120	$6.2M
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…	52,180	$80	$3.9M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	1,970	$1,080	$2.1M
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…	12,510	$140	$1.7M
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…	4,740	$220	$1.1M
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…	3,820	$180	$679.4K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	8,530	$60	$520.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	11,450	$40	$503.7K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	4,280	$120	$496.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	2,890	$160	$470.9K

Showing 1–10 of 196

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Sansum Clinic — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

196 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	114	120	380	$970	$1.1M
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	26	230	270	$840	$717.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	501	780	1,160	$130	$576.2K
G6015	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session	36	40	990	$180	$558K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	197	360	840	$160	$495.3K
J0897	Injection, denosumab, 1 mg	73	90	160	$830	$415.2K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	216	360	880	$130	$408.5K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	326	380	210	$510	$333.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	689	1,080	460	$110	$263.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	73	230	310	$280	$247.2K

Showing 1–10 of 196

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nathan Steinle	CA	Retina Specialist (Ophthalmology) Physician	$9.5M	$0
Stephen Couvillion	CA	Retina Specialist (Ophthalmology) Physician	$6.4M	$0
Alessandro Castellarin	CA	Retina Specialist (Ophthalmology) Physician	$5.4M	$0
William Pace	CA	Nuclear Medicine Physician	$4.1M	$0
Dante Pieramici	CA	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Daniel Greenwald	CA	Medical Oncology Physician	$3.5M	$0
Ma'an Nasir	CA	Retina Specialist (Ophthalmology) Physician	$3M	$0
Julian Davis	CA	Hematology & Oncology Physician	$2.7M	$0
David Carlson	CA	Nuclear Medicine Physician	$2.6M	$0
Mukul Gupta	CA	Medical Oncology Physician	$2.3M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hillside House, Inc.	CA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$35.6M
Santa Barbara Outpatient Surgery Centers LLC	CA	Ambulatory Surgical Clinic/Center	$3M	$0
Cold Springs Medical Surgical Group LLC	CA	Ambulatory Surgical Clinic/Center	$633.1K	$1.6M
Sansum Clinic	CA	Ambulatory Surgical Clinic/Center	$1.4M	$699.5K
Gregg Newman	CA	Hematology & Oncology Physician	$2M	$0
Justin Voog	CA	Radiation Oncology Physician	$1.6M	$0
Coastal Surgery Center Partners	CA	Ambulatory Surgical Clinic/Center	$935.2K	$544.3K
Mark Burnett	CA	MOHS-Micrographic Surgery Physician	$1.4M	$0
Wonsuk Suh	CA	Radiation Oncology Physician	$1.3M	$0
Gold Coast Surgery Center	CA	Ambulatory Surgical Clinic/Center	$1.2M	$6.5K

Sansum Clinic — Billing Profile & Reimbursement Data

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Sansum Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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