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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Katie Jones (NPI 1932464435)

Field	Value
Entity Type	Individual
Organization	Katie Jones
Address	400 22nd Ave.
City	Brookings
State	SD
ZIP	57002
Taxonomy	Family Nurse Practitioner
NPI Enumerated	July 10, 2012

Payer Source	Total Paid
Medicare	$22.5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 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…	380	$40	$15.5K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	120	$20	$2.6K
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…	40	$50	$2.1K
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	$1.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	30	$30	$850

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. South Dakota Distribution

Katie Jones — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	1,443	1,660	90	$70	$11.4K
99213	105	1,710	80	$50	$6.4K
11042	28	30	100	$40	$5.3K
97597	6	20	120	$40	$5.1K
99203	206	600	30	$60	$2.9K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sanford Medical Center	SD	Family Medicine Physician	$0	$68.8M
Rural Health Care, Inc	MN	Federally Qualified Health Center (FQHC)	$0	$15.9M
Rural Health Care, Inc	MN	Federally Qualified Health Center (FQHC)	$0	$10.1M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$2.1M
City Of Brookings	SD	Multi-Specialty Clinic/Center	$0	$1.2M
City Of Brookings	SD	Anesthesiology Physician	$0	$551.5K
City Of Brookings	SD	General Acute Care Hospital	$0	$548.5K
Rural Health Care, Inc.	SD	Federally Qualified Health Center (FQHC)	$0	$233.9K
Tarek Mahrous	SD	Interventional Cardiology Physician	$210.6K	$0

Katie Jones — Billing Profile & Reimbursement Data

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Katie Jones — 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