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

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

Elisabeth Balken (NPI 1992489728)

Field	Value
Entity Type	Individual
Organization	Elisabeth Balken
Address	9192 W Union Hills Dr
City	Peoria
State	AZ
ZIP	85382
Taxonomy	Nurse Practitioner
NPI Enumerated	June 12, 2023

Payer Source	Total Paid
Medicare	$23.3M
Medicaid	$0

Key Findings

This provider is a Nurse Practitioner (NPI enumerated 2023-06-12 (~3 years ago)) practicing in PEORIA, AZ, and the Medicare dataset dominates her billing profile: Total Medicare revenue is $23.3M while there is no Medicaid billing on file. The absence of Medicaid activity makes this effectively a single-payer Medicare practice in the available claims data, concentrating payer risk and exposure to fee-schedule or coverage changes on the Medicare side.

Revenue is extremely concentrated in a very small set of CPT/HCPCS lines: the precomputed top-3 Medicare codes account for 100.0% of this provider's total Medicare revenue. In the reported detail, Q4262 alone is shown with $23.3M revenue (100.0% of this provider's total Medicare revenue), indicating almost all Medicare dollars flow through a single code or tightly related set of services.

Q4262 (29.5K claims, $789 avg paid/claim, $23.3M revenue) drives the practice financially and ranks #7 of 141 providers nationally (96th percentile). Although that rank places the provider among the top national billers for Q4262, the code-level annotation describes the provider’s volume for this code as "typical, unremarkable volume for this code," so the dataset flags high rank but not an exceptional outlier label in plain-English terms.

15274 (169 claims, $54 avg paid/claim, $9.1K revenue) appears in the top codes list but contributes a negligible share of revenue (0.0% of this provider's total Medicare revenue) compared with Q4262. Its national position (#28 of 46 providers, 40th percentile) and the accompanying plain-English label of "typical, unremarkable volume" suggest this code is an ancillary or infrequent add-on in this provider’s service mix rather than a core revenue driver.

The code descriptions and the add-on nature of Q4262 and 15274 indicate a clinical focus on wound care and skin substitute procedures (Q4262: dual layer impax membrane per square centimeter add-on; 15274: skin substitute covering up to an additional 100 cm2). This pattern is consistent with a practice model that performs many procedural add-on services—likely repeat applications or matrix-type wound treatments—rather than a broad primary-care billing mix.

From a competitive-stance perspective, the provider is a major national-level participant for Q4262 by rank (#7 of 141), yet the plain-English statistical labeling does not mark this as an extreme outlier; for other codes like 15274 the provider is a modest participant. That combination—very high dollar concentration in one code but typical volume labels—suggests market specialization rather than broad-based dominance across multiple procedure types.

Operationally, the combination of a recent NPI enumeration (2023-06-12 (~3 years ago)), very high Medicare revenue ($23.3M), and zero Medicaid billing on file implies rapid revenue scale-up through a narrow set of procedural codes. Analysts should treat future changes to Medicare policy on these add-on codes or coverage rules for skin substitutes as material risk or opportunity for this provider’s revenue stream.

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
Q4262	Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)	29,500	$790	$23.3M
15274	The provider uses a skin substitute such as an allograft or xenograft to cover a trunk, arms, and/or legs wound surface area of up to an additional 100 cm2 in a patient 10 years or older, or 1…	170	$50	$9.1K

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. Arizona Distribution

Elisabeth Balken — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q4262	7	10	31,870	$890	$43.9M
15274	6	10	310	$60	$22.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jorge Kinds	AZ	Family Nurse Practitioner	$123.9M	$0
Keith Goss	AZ	Foot & Ankle Surgery Podiatrist	$91.3M	$0
Gina Palacios	AZ	Nurse Practitioner	$27M	$0
Eric Ogari	AZ	Family Nurse Practitioner	$6.9M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Partners	AZ	Home Health Agency	$0	$77.6M
Pleasant Pediatrics Plc	AZ	Pediatrics Physician	$1.2K	$33.2M
Pacifica Senior Living Peoria	AZ	Alzheimer Center (Dementia Center)	$0	$11.1M
Pediatric Partners LLC	AZ	Speech-Language Pathologist	$0	$7.1M
Southwest Network	AZ	Community/Behavioral Health Agency	$0	$6.6M
Brea Peoria, LLC	AZ	Assisted Living Facility	$0	$6.2M
Grant Fankhauser	AZ	Vascular Surgery Physician	$1.4M	$0
David Nye	AZ	Vascular Surgery Physician	$905.8K	$0
Dane Hill	AZ	Dermatology Physician	$882.4K	$0
Han Choi	AZ	Dentist	$521.6K	$0

Elisabeth Balken — Billing Profile & Reimbursement Data

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Elisabeth Balken — 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