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

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

Herbert Kloss, M.d. PLLC (NPI 1972873842)

Field	Value
Entity Type	Organization
Organization	Herbert Kloss, M.d. PLLC
Address	5057 84th Ave Se
City	Mercer Island
State	WA
ZIP	98040
Taxonomy	Pediatric Anesthesiology Physician
NPI Enumerated	January 9, 2012

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D9223	N/A	5,520	$410	$2.3M
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	5,520	$290	$1.6M
D9222	N/A	5,520	$80	$447.3K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Washington providers billing the same CPT/HCPCS codes.

Claims Volume vs. Washington Distribution

Herbert Kloss, M.d. PLLC — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. Washington median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2035	Utility services to support medical equipment and assistive technology/devices, waiver	8	50	850	$300	$1.1M
D9223	N/A	18	90	750	$280	$893.8K
D9222	N/A	14	90	700	$80	$229.2K

Nearby Providers

Other providers in the same ZIP code as Herbert Kloss, M.d. PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pacific Northwest Dental Anesthesia Services LLC	WA	Dental Anesthesiology	$0	$3.3M
Washington Cvs Pharmacy LLC	WA	Pharmacy	$317.6K	$0
Laura Curtis	WA	Adult Health Nurse Practitioner	$114.6K	$0
Brenda Newman	WA	Dermatology Physician	$99K	$0
Mak Abulhosn	WA	Podiatrist	$63.2K	$0
Jennifer Hall	WA	Medical Physician Assistant	$41.7K	$0

Herbert Kloss, M.d. PLLC — Billing Profile & Reimbursement Data

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Herbert Kloss, M.d. PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References