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

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

Roberto Canales M.d. P.A. (NPI 1023237518)

Roberto Canales M.d. P.A. is a pediatrics physician provider located in El Paso, Texas. This profile covers 0 Medicare and 93 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Roberto Canales M.d. P.A.
Address	1733 Curie Dr Ste 103
City	El Paso
State	TX
ZIP	79902
Taxonomy	Pediatrics Physician
NPI Enumerated	April 24, 2007

Payer Source	Total Paid
Medicaid	$18.3M
Medicare	$0

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	70,300	$40	$2.8M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	31,520	$50	$1.6M
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…	23,540	$60	$1.3M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10,550	$90	$981.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,820	$90	$963.3K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	8,120	$110	$917.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	29,200	$30	$788.3K
87804	The 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.	55,590	$10	$778.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,920	$190	$761.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,990	$90	$687.4K

Showing 1–10 of 93

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Texas providers billing the same CPT/HCPCS codes.

Claims Volume vs. Texas Distribution

Roberto Canales M.d. P.A. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

93 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	12	30	1,140	$370	$1.2M
93229	In this procedure, the provider, typically a technician, places a wearable electrocardiographic monitoring device on the patient, instructs him in its use, and monitors the transmissions, to detect…	3	10	60	$110	$685.6K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	10	70	850	$180	$621.2K
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…	70	6,040	710	$40	$232.8K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	34	210	260	$120	$221.2K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	16	70	960	$60	$210.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	80	1,500	880	$80	$185.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	140	1,360	800	$80	$185.6K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	59	220	130	$80	$180.8K
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…	141	5,810	540	$50	$155.5K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grace Personal Assistance Services LLC	TX	In Home Supportive Care Agency	$0	$45.7M
El Paso Healthcare System Ltd	TX	General Acute Care Hospital	$0	$38.5M
Abundant Living Home Health	TX	Personal Care Attendant	$0	$30.9M
Valor Personal Assistance Service, Inc.	TX	Personal Care Attendant	$0	$25.8M
Amor Personal Assistance Service, Inc.	TX	In Home Supportive Care Agency	$0	$23.8M
Always Caring Health Care Services Inc	TX	Home Health Agency	$0	$18.9M
La Familia Del Paso, Inc	TX	Community/Behavioral Health Agency	$0	$16.4M
Nuevo Hogar Home Care Providers LLC	TX	In Home Supportive Care Agency	$0	$15.7M
Tenet Hospitals Limited	TX	General Acute Care Hospital	$0	$15.7M
Santa Teresa Provider Assisted Services LLC	TX	Home Health Agency	$0	$14.7M

Roberto Canales M.d. P.A. — Billing Profile & Reimbursement Data

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Roberto Canales M.d. P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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