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

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

Elsa Raymond (NPI 1972057420)

Field	Value
Entity Type	Individual
Organization	Elsa Raymond
Address	916 Talon Dr
City	O Fallon
State	IL
ZIP	62269
Taxonomy	Family Nurse Practitioner
NPI Enumerated	August 12, 2016

Payer Source	Total Paid
Medicare	$103K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 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…	1,130	$80	$88.3K
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…	130	$50	$7K
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	$90	$3.6K
20611	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa, typically the shoulder, hip, knee, or subacromial bursa, and then uses the syringe…	40	$80	$3K
62367	The provider analyzes performance of an implantable pump but does not reprogram or refill the pump. Intrathecal or epidural pumps may be used to deliver pain medications or chemotherapy to patients…	70	$20	$1.5K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	50	$1	$50

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Illinois Distribution

Elsa Raymond — 2 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	199	18,540	110	$80	$17.1K
20611	274	390	80	$80	$12.2K
99213	5,756	17,390	70	$60	$8.8K
99204	3,575	8,580	30	$110	$5.6K
62367	1	10	30	$20	$730
J3301	1,235	1,460	180	$1	$400

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Hodgkiss	TN	Diagnostic Radiology Physician	$458.9K	$0
Wynndel Buenger	IL	Pain Medicine Physician	$399.4K	$4.5K
Anthony Guarino	IL	Anesthesiology Physician	$192.3K	$0
William Thom	IL	Pain Medicine (Anesthesiology) Physician	$78.2K	$42.5K
Tricia Clayton	IL	Family Nurse Practitioner	$90.7K	$4.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southern Illinois Healthcare Foundation Inc	IL	Federally Qualified Health Center (FQHC)	$0	$7.9M
Ssm Cardinal Glennon Childrens Hospital	IL	Pediatrics Physician	$0	$5.4M
John Visconti	IL	Medical Oncology Physician	$2.8M	$149.1K
Bassam Maalouf	IL	Hematology & Oncology Physician	$1.8M	$770.9K
Brett Herzog	IL	Medical Oncology Physician	$1.9M	$40.7K
Justin Floyd	IL	Medical Oncology Physician	$1.3M	$336.2K
Mark Walshauser	IL	Hematology & Oncology Physician	$437.5K	$395.5K
O'fallon Surgical Center, LLC	IL	Ambulatory Surgical Clinic/Center	$793.7K	$0
Scott Roustio	IL	Emergency Medicine Physician	$83.8K	$625.5K
Michael Stock	IL	Ophthalmology Physician	$669.2K	$0

Elsa Raymond — Billing Profile & Reimbursement Data

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Elsa Raymond — 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

Nearby Providers

Frequently Asked Questions

References