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

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

Jose Sanclement (NPI 1982721098)

Field	Value
Entity Type	Individual
Organization	Jose Sanclement
Address	825 Ne 10th
City	Oklahoma City
State	OK
ZIP	73104
Taxonomy	Plastic Surgery within the Head & Neck (Otolaryngology) Physician
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicare	$19.9K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 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…	70	$70	$4.8K
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…	100	$50	$4.6K
15004	The provider prepares the skin of a body part with an open wound, burn eschar, or scar contracture to receive a skin graft. This procedure helps in repairing areas of the face, scalp, eyelids, mouth,…	20	$200	$3.2K
31641	In this procedure, the provider performs rigid or flexible bronchoscopy to view airways during a procedure. She may or may not use fluoroscopic guidance. She uses a nonexcision method, such as by…	10	$190	$2.5K
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…	20	$100	$2.4K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	40	$50	$1.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	20	$30	$460

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oklahoma Distribution

Jose Sanclement — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oklahoma

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	3,774	5,560	130	$70	$18.4K
15004	7	10	20	$210	$9.6K
99213	2,482	5,450	80	$50	$8.7K
99204	1,786	2,790	40	$100	$5.8K
31575	46	80	40	$80	$4.2K
31641	1	10	10	$190	$2.5K
99212	847	1,100	30	$30	$2.3K

Jose Sanclement — Billing Profile & Reimbursement Data

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Jose Sanclement — 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