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

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

Sandra Kirksey (NPI 1972960078)

Field	Value
Entity Type	Individual
Organization	Sandra Kirksey
Address	Po Box 211699
City	Eagan
State	MN
ZIP	55121
Taxonomy	Nurse Practitioner
NPI Enumerated	January 20, 2016

Payer Source	Total Paid
Medicare	$40.1K
Medicaid	$0

Key Findings

This provider bills almost exclusively to Medicare, reporting Total Medicare revenue of $40.1K and no Medicaid billing on file; the NPI was enumerated 2016-01-20 (~10 years ago), indicating roughly a decade of participation in Medicare billing. The absence of Medicaid activity makes this effectively a single-payer Medicare billing profile for payer mix analysis and contracting considerations.

Revenue is highly concentrated in a small set of services: the top three Medicare codes 99496, 99213, and 99349 account for 59.3% of the provider’s total Medicare revenue. That concentration suggests a narrow set of service lines drive the bulk of billing and financial performance.

The code mix points to a practice model centered on transitional care and longitudinal outpatient/home-based evaluation and management: 99496 and 99495 are transition-of-care management codes, while 99349, 99348 and 99347 are home/residence E/M visits and 99213/99214/99204 are office E/M visits. This mix implies significant post-discharge and home-visit workflows alongside routine office follow-ups, consistent with a nurse practitioner delivering hands-on, time-intensive patient management.

Claim-level patterns show different drivers of revenue and volume: 99213 has the largest claim count at 140 claims with an avg paid/claim of $60 producing $8.4K revenue, while 99496 has 57 claims at an avg paid/claim of $182 producing $10.4K revenue. In other words, 99496 yields the single highest revenue contribution per claim even though 99213 is the highest-volume code by claim count.

Competitive standing varies by code: 99496 ranks #1036 of 15461 providers nationally (93th percentile) yet is described as "typical, unremarkable volume for this code," indicating a relatively strong but not exceptional position for transitional care management; 99213 ranks in the 69th percentile and 99349 in the 37th percentile and are both labeled as "typical, unremarkable volume." Overall, the provider is a modest national participant with one comparatively higher standing for 99496 but otherwise typical volumes across top E/M codes.

From a payer strategy perspective, the lack of Medicaid billing reduces this provider’s exposure to state Medicaid programs and related value-based initiatives; payers seeking Medicaid-network breadth are unlikely to find this provider active on that payer. Conversely, Medicare-focused programs that emphasize transitional care management or home visits (e.g., post-discharge care bundles) may align with the provider’s existing billed services.

Across the top codes there are no labels indicating statistical outlier behavior; most top codes are explicitly characterized as "typical, unremarkable volume for this code." That pattern suggests the provider’s billing falls within common national practice patterns rather than representing extreme or anomalous utilization for these services.

Medicare: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	60	$180	$10.4K
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…	140	$60	$8.4K
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…	60	$90	$5K
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…	50	$90	$4.4K
99495	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires at least moderate medical decision making,…	30	$140	$4.4K
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…	30	$110	$3.6K
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…	70	$50	$3.3K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	20	$30	$720

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 8 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Minnesota Distribution

Sandra Kirksey — 1 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. state median

8 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99349	1	340	80	$80	$16.2K
99214	10	10,100	70	$80	$8.1K
99213	6	9,120	50	$50	$4K
99204	2	3,340	20	$110	$3.6K
99496	1	70	20	$180	$3.4K
99348	1	210	50	$40	$3.1K
99495	1	210	20	$140	$2.9K
99347	1	60	30	$30	$1.9K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Samir Azzam	CA	Family Medicine Physician	$298.7K	$963.6K
Shrikant Tamhane	CA	Family Medicine Physician	$722.5K	$353.8K
Ngoc Nguyen	CA	Cardiovascular Disease Physician	$986.9K	$6.4K
Nila Alsheik	IL	Diagnostic Radiology Physician	$332.8K	$300.3K
Christopher Leach	CA	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$444.7K	$0
Jamie Giesbrandt	NM	Diagnostic Radiology Physician	$385.5K	$0
Khasha Touloei	CA	Dermatology Physician	$351.4K	$0
Maryam Seddigh Tonekaboni	CA	Family Medicine Physician	$323.9K	$0
Johnathan Hays	VA	Diagnostic Radiology Physician	$275K	$32K
Brady Banta	MT	Diagnostic Radiology Physician	$279K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Respiratory Services, LLC	MN	Oxygen Equipment & Supplies (DME)	$0	$43.4M
People Incorporated	MN	Case Management Agency	$0	$22.2M
David Ridley	MN	Rheumatology Physician	$2.2M	$0
Summit Orthopedics Ltd	MN	Ambulatory Surgical Clinic/Center	$1.5M	$0
Eagan Orthopedic Surgery Center LLC	MN	Ambulatory Surgical Clinic/Center	$1M	$0
Elvia Moreta Freire	MN	Rheumatology Physician	$638.6K	$0
Kristoffer Breien	MN	Orthopaedic Surgery Physician	$143.6K	$0
Costco Wholesale Corporation	MN	Community/Retail Pharmacy	$92.1K	$0
Makenna Pechumer	MN	Gerontology Nurse Practitioner	$49.8K	$0
Bruce Thordal	MN	Cognitive & Behavioral Psychologist	$29.4K	$0

Sandra Kirksey — Billing Profile & Reimbursement Data

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Sandra Kirksey — 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