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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Carl Gilmore (NPI 1003012493)

Field	Value
Entity Type	Individual
Organization	Carl Gilmore
Address	Msc08 4770
City	Albuquerque
State	NM
ZIP	87131
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	June 22, 2007

Payer Source	Total Paid
Medicare	$171.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
27447	In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The…	60	$980	$58.6K
23472	In this procedure, the provider performs a total shoulder arthroplasty in which the provider replaces the damaged head of the humerus and the glenoid cavity with prosthetic implants. The provider…	20	$1,110	$25.6K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	520	$50	$24.8K
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…	290	$60	$16.8K
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…	180	$90	$15.8K
99203	The provider sees a new 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 provider…	100	$70	$6.4K
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…	60	$110	$6.1K
73564	In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area.	200	$30	$5.6K
73562	In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area.	110	$30	$3.1K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,750	$1	$2.8K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Carl Gilmore — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
27447	15	70	40	$1,270	$52.1K
23472	5	20	20	$770	$13.8K
99214	761	2,700	90	$70	$12.9K
99213	284	2,440	60	$50	$7.3K
20610	4	210	50	$50	$4.9K
99204	295	1,210	30	$100	$4.5K
73721	30	50	20	$80	$4.1K
73221	29	40	30	$90	$4.1K
99203	118	870	30	$60	$3.3K
73564	14	100	50	$20	$1.9K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Taos Health Systems, Inc., Holy Cross Hospital	NM	Critical Access Hospital	$0	$30.9M
New Mexico Orthopaedic Associates PC	NM	Orthopaedic Surgery Physician	$0	$16.2M
Taos Professional Services,llc	NM	Surgery Physician	$0	$2.5M
William Breland	TX	Physical Therapist	$342.3K	$0
Branko Huisa	CA	Neurology Physician	$300.4K	$0
Daniel Junick	NM	Orthopaedic Surgery Physician	$255K	$0
Krishna Tripuraneni	NM	Adult Reconstructive Orthopaedic Surgery Physician	$223.5K	$0
Joshua Carothers	NM	Adult Reconstructive Orthopaedic Surgery Physician	$204.6K	$0
John Bowden	NM	Dermatology Physician	$198.7K	$0
Douglas Orndorff	NM	Orthopaedic Surgery of the Spine Physician	$198.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andrew Bruner	NM	Diagnostic Radiology Physician	$128.8K	$920
Edo Avochinou	NM	Internal Medicine Physician	$125.6K	$0
William Schaeffer	NM	Vascular & Interventional Radiology Physician	$125.3K	$0
Kurt Pedrotty	NM	Diagnostic Radiology Physician	$118.7K	$0
Wallace Gladden	NM	Physical Medicine & Rehabilitation Physician	$113.5K	$0
David Martin	NM	Anatomic Pathology & Clinical Pathology Physician	$109K	$0
Reuel Measom	NM	Interventional Pain Medicine Physician	$106.2K	$0
Jennifer Pohl	NM	Diagnostic Radiology Physician	$105.6K	$0
Eddie Brown	NM	Cardiovascular Disease Physician	$104.2K	$0
Matthew Goodstein	NM	Student in an Organized Health Care Education/Training Program	$100.4K	$0

Carl Gilmore — Billing Profile & Reimbursement Data

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Carl Gilmore — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References