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.

Elliot Cain (NPI 1962879551)

Field	Value
Entity Type	Individual
Organization	Elliot Cain
Address	2801 W Kinnickinnic River Pkwy
City	Milwaukee
State	WI
ZIP	53215
Taxonomy	Physician Assistant
NPI Enumerated	August 31, 2015

Payer Source	Total Paid
Medicare	$4.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
33533	Coronary artery bypass, using arterial graft(s); single arterial graft	20	$150	$2.5K
33405	The provider replaces the aortic valve with an artificial valve (but not a homograft or ventless valve) via open access with the patient on cardiopulmonary bypass. She performs this procedure to…	10	$170	$2.2K
33508	The provider employs surgical endoscopy to visualize structures surrounding the vein he harvests for a coronary artery bypass procedure.	20	$1	$20

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Wisconsin Distribution

Elliot Cain — 0 of 3 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

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33405	8	10	20	$1,130	$19.1K
33533	26	50	20	$780	$16.4K
33508	27	50	20	$10	$170

Elliot Cain — Billing Profile & Reimbursement Data

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Elliot Cain — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References