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

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

Ernesto Pinzon (NPI 1013950542)

Field	Value
Entity Type	Individual
Organization	Ernesto Pinzon
Address	2950 Alt Us Hwy 27 S
City	Sebring
State	FL
ZIP	33870
Taxonomy	Nephrology Physician
NPI Enumerated	June 13, 2006

Payer Source	Total Paid
Medicare	$525K
Medicaid	$0

Medicare: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	3,190	$50	$152.9K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,210	$40	$81.8K
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…	1,000	$60	$62.9K
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…	470	$90	$43.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	380	$100	$36.5K
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	870	$30	$29.6K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	200	$130	$25.7K
90962	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	140	$160	$21.5K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	220	$80	$18.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	90	$140	$12.4K

Showing 1–10 of 19

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 19 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Florida Distribution

Ernesto Pinzon — 3 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. state median

19 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	6,109	32,760	140	$90	$25K
99233	1,477	9,970	100	$90	$20.1K
99490	19	1,200	150	$50	$19.7K
99291	2,278	4,770	50	$170	$15.7K
G0439	1,198	7,210	60	$120	$13.4K
99223	3,738	11,110	60	$130	$12.5K
99213	902	30,010	80	$60	$12K
99439	6	540	110	$30	$8.7K
90962	9	150	30	$160	$7.9K
99204	6,397	19,040	40	$110	$7K

Showing 1–10 of 19

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
National Medical Care, Inc.	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$9.5M
F&s Radiology, P.C.	FL	Diagnostic Radiology Physician	$0	$7.5M
Highlands County Board Of County Commissioners	FL	Land Ambulance	$1.7M	$1.8M
Scott Gasiorek	FL	Radiation Oncology Physician	$3M	$0
Darrin Rotman	FL	Dermatology Physician	$2.7M	$0
Mahender Yellu	FL	Medical Oncology Physician	$2.6M	$0
Amit Shah	FL	Medical Oncology Physician	$2M	$0
Syed Ahmed	FL	Medical Oncology Physician	$1.2M	$0
Thomas Lackey	FL	Surgery Physician	$1.1M	$61.7K
Winter Haven-sebring Fl Ophthalmology Asc LLC	FL	Ambulatory Surgical Clinic/Center	$923K	$0

Ernesto Pinzon — Billing Profile & Reimbursement Data

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Ernesto Pinzon — 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