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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Hoke Shirley (NPI 1962432047)

Field	Value
Entity Type	Individual
Organization	Hoke Shirley
Address	246 Pleasant St Ste 210
City	Concord
State	NH
ZIP	03301
Taxonomy	Rheumatology Physician
NPI Enumerated	July 4, 2006

Payer Source	Total Paid
Medicare	$407K
Medicaid	$0

Key Findings

This provider reported total Medicare revenue of $407K and has no Medicaid billing on file; the public-payer footprint is therefore effectively single-payer Medicare rather than a blended Medicare/Medicaid practice. The absence of any Medicaid claims suggests this clinician either does not contract with Medicaid or bills other payers (commercial/self-pay) outside the public dataset, so Medicare policy and utilization will drive visible public revenue trends for this NPI.

Revenue is highly concentrated in three codes: J0897 ($229K, 57.3% of Medicare revenue), 99214 ($76K, 19.0%), and 99213 ($41.2K, 10.3%), which together account for 86.6% of this provider’s Medicare revenue (precomputed). This concentration indicates that a small set of services—one drug administration code and two E/M visit codes—dominate the payer-side revenues recorded here.

The code mix aligns with a rheumatology-oriented outpatient practice that administers biologic or specialty injectable therapy and manages established patients in clinic. Specifically, heavy J0897 use (injection, denosumab) alongside high-volume office visits 99214 and 99213, plus procedure codes such as 20610 (joint injections) and 77080 (DXA), is consistent with a practice model centered on regular injections/infusions, disease management visits, and bone density monitoring.

Operationally, J0897 is a high-claim, low-unit-payment driver (12.7K claims at $18 avg paid/claim producing $229K revenue) while 99214 is a lower-claim, higher-unit-payment driver (817 claims at $93 avg paid/claim producing $76K revenue). This pattern points to a mix of frequent procedural/service encounters and routine E/M visits where volume dynamics (claim counts) are as important to revenue as per-claim reimbursement rates.

Competitive standing varies by code: J0897 ranks #741 of 10057 providers nationally (93th percentile; typical, unremarkable volume for this code), indicating the provider’s denosumab activity is not an extreme outlier despite a large share of their Medicare revenue. In contrast, both 99214 and 99213 rank in the 96th percentile nationally and are labeled "notably above typical national volume," signifying stronger-than-typical visit volumes compared with peers for those E/M services.

Several ancillary codes show mixed competitive signals: 96372 ranks in the 94th percentile (typical, unremarkable volume for this code), suggesting relatively high injection/administration activity that still falls in a typical range, while J1740 ranks #11 of 13 providers nationally (17th percentile; typical, unremarkable volume for this code), indicating negligible contribution and a very small national peer sample for that medication code. DXA imaging (77080) and joint-procedure codes (20610 family) appear at more typical percentiles (60th–83th) and contribute modestly to revenue.

The NPI was enumerated on 2006-07-04 (~20 years ago), indicating long tenure; this duration is consistent with an established outpatient referral base and sustained Medicare billing history. For analysts, tenure plus the top-code concentration suggests stability of clinical focus over time rather than a newly shifted service mix.

Given the concentrated dependence on Medicare and on a single drug administration code plus office visits, changes in Medicare coverage, reimbursement, or local formulary access for denosumab (J0897) and shifts in E/M policy could materially affect the reported public revenue profile. Analysts should prioritize review of Medicare reimbursement trends for J0897 and utilization patterns for 99214/99213 when modeling future revenue exposure for this provider.

Medicare: Complete Services Breakdown

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

28 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0897	Injection, denosumab, 1 mg	12,720	$20	$229K
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…	820	$90	$76K
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…	650	$60	$41.2K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	190	$50	$10K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	100	$70	$7.3K
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…	40	$130	$5K
77080	The provider performs an imaging procedure, called dual–energy X–ray absorptiometry (DXA), of one or more bony areas on the trunk to determine the bone mineral density (BMD) and whether the patient…	100	$40	$3.9K
G0008	Administration of influenza virus vaccine	110	$30	$3.5K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	310	$10	$3.4K
99441	N/A	70	$40	$2.7K

Showing 1–10 of 28

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 28 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Hoke Shirley — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. state median

28 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0897	1	20	2,760	$20	$75.4K
99214	49	3,150	110	$80	$13.2K
99213	49	2,900	70	$50	$6.9K
90662	82	360	40	$70	$5.4K
99204	562	1,340	30	$100	$4.6K
20610	42	250	50	$50	$4.5K
G0008	193	510	70	$30	$4.1K
77002	30	70	30	$60	$2.9K
77080	48	120	70	$20	$2K
J1740	1	10	90	$20	$1.9K

Showing 1–10 of 28

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Concord Hospital, Inc.	NH	General Acute Care Hospital	$0	$28.8M
Concord Hospital-laconia	NH	General Acute Care Hospital	$0	$9.3M
Concord Hospital, Inc.	NH	General Practice Physician	$0	$3.7M
Concord Hospital-laconia	NH	Medicare Defined Swing Bed Hospital Unit	$0	$2.9M
Concord Hospital-laconia	NH	Family Medicine Physician	$0	$2.5M
Concord Hospital, Inc.	NH	Emergency Medicine Physician	$0	$2.5M
Concord Orthopaedics Professional Association	NH	Orthopaedic Surgery Physician	$0	$646.8K
Jeffrey Wiley	NH	Orthopaedic Surgery Physician	$317.2K	$0
Neil Dion	NH	Orthopaedic Surgery Physician	$276.5K	$0
Jason Desmarais	NH	Orthopaedic Surgery Physician	$267.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Bridges	NH	Case Management Agency	$0	$265.5M
Riverbend Community Mental Health, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$118.4M
Granite State Independent Living	NH	In Home Supportive Care Agency	$0	$74.7M
Ascentria Community Services, Inc	NH	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$52.6M
Ascentria Community Care, Inc	NH	Voluntary or Charitable Agency	$0	$50.3M
Concord Pediatric Dentistry	NH	Pediatric Dentistry	$0	$13.6M
New England Life Care, Inc.	NH	Home Infusion Therapy Pharmacy	$0	$11.4M
New Hampshire Home Care Providers LLC	NH	In Home Supportive Care Agency	$0	$11M
Brain Injury Association Of Nh	NH	Case Management Agency	$0	$11M
Metro Treatment Of New Hampshire, LP	NH	Methadone Clinic	$404K	$10.4M

Hoke Shirley — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References