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

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

Sarah Smith (NPI 1992364400)

Field	Value
Entity Type	Individual
Organization	Sarah Smith
Address	708 Funderburk Ave
City	Houma
State	LA
ZIP	70364
Taxonomy	Physician Assistant
NPI Enumerated	June 8, 2019

Payer Source	Total Paid
Medicare	$1.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	20	$70	$1.6K
99281	The provider sees a patient for the lowest level emergency department visit.	30	$10	$180

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Louisiana Distribution

Sarah Smith — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	946	1,150	50	$90	$5.8K
99281	3	10	20	$10	$160

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lee Grafton	LA	Dermatology Physician	$388.6K	$0
Patrick Walker	LA	Internal Medicine Physician	$185.9K	$0
Tamela Charbonnet	LA	Dermatology Physician	$154.4K	$0
Kristal Guidroz	LA	Dermatology Physician	$94.5K	$0
Denton Paige	LA	Physician Assistant	$37.3K	$0
Malcolm Dugas	LA	Clinical Social Worker	$19.8K	$8.6K

Sarah Smith — Billing Profile & Reimbursement Data

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Sarah Smith — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References