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    OpenPayerNPI Medicare & MedicaidAdolfo Sanchez
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    Adolfo Sanchez — Billing Profile & Reimbursement Data

    NPI 1003117698 · Belen, NM · Family Medicine Physician

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    Adolfo Sanchez is a family medicine physician provider located in Belen, New Mexico. This profile covers 17 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAdolfo Sanchez
    Address703 South Christopher Road
    CityBelen
    StateNM
    ZIP87002
    TaxonomyFamily Medicine Physician
    NPI EnumeratedNovember 12, 2010

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$95.1K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…690$80$52K
    99213The 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…520$60$30.4K
    99204The 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…40$100$3.8K
    96372A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…260$10$2.3K
    20610In 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…40$50$1.9K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit10$120$1.3K
    G0008Administration of influenza virus vaccine40$30$1.2K
    90686This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…50$20$1.2K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.40$20$670
    81000The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…60$1$220

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99214992,70090$70$12.9K
    G043947549050$120$9.7K
    992131142,44060$50$7.3K
    2061012521050$50$4.9K
    992044841,21030$100$4.5K
    G000826148060$30$3K
    87804288040$20$770
    963721430040$10$720
    9068677020$20$520
    J201031030$10$440

    Showing 1–10 of 17

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Roland Kent Sanchez, MdNMFamily Medicine Physician$0$1.6M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ambercare Home Health Care CorporationNMHome Health Agency$0$518M
    Recovery Services Of New Mexico, LLCNMMethadone Clinic$94.6K$10.5M
    Heart & Soul Of Nm, IncNMCommunity/Behavioral Health Agency$0$7.2M
    David L WrightNMMental Health Counselor$0$2.5M
    Herron Solutions LLCNMCommunity/Behavioral Health Agency$0$2.4M
    Cassandra OteroNMMedical Physician Assistant$32.7K$53.3K
    Michael GuruleNMCardiovascular Disease Physician$71.2K$0
    Angela NapierNMNurse Practitioner$40.7K$0
    Jon OteroNMPhysical Therapist$21.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

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    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. New Mexico Distribution
    Adolfo Sanchez — 3 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — New Mexico