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.

Paulette Whalen (NPI 1932717410)

Field	Value
Entity Type	Individual
Organization	Paulette Whalen
Address	W267s7535 Olympia Ct N
City	Waukesha
State	WI
ZIP	53189
Taxonomy	Nurse Practitioner
NPI Enumerated	July 21, 2020

Payer Source	Total Paid
Medicare	$102.4K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	520	$120	$60.8K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	380	$80	$30.3K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	40	$100	$4.3K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	50	$50	$2.6K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	20	$120	$2.2K
G0318	Prolonged home or residence 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 of the primary…	90	$20	$1.8K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	10	$50	$540

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Paulette Whalen — 1 of 7 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

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99349	31	190	80	$80	$15.2K
99350	6	130	50	$120	$13.3K
G0439	1,426	2,350	50	$120	$9.1K
99348	155	160	50	$40	$4K
99497	73	190	40	$60	$3.5K
99345	38	70	20	$120	$3.2K
G0318	5	20	40	$20	$1.4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Williams	WI	Family Medicine Physician	$381.1K	$780
Mary Friess	WI	Family Nurse Practitioner	$328K	$15.8K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Keith Beck	WI	Foot & Ankle Surgery Podiatrist	$70.4K	$17.4K

Paulette Whalen — 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

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Frequently Asked Questions

References