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NPI 1093178766 · Las Cruces, NM · Family Nurse Practitioner
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Jaime Sanchez is a family nurse practitioner provider located in Las Cruces, New Mexico. This profile covers 22 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Jaime Sanchez |
| Address | 530 N Telshor Blvd Ste A |
| City | Las Cruces |
| State | NM |
| ZIP | 88011 |
| Taxonomy | Family Nurse Practitioner |
| NPI Enumerated | March 31, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1.2M |
| Medicaid | $33.9K |
This provider’s billing pattern is heavily weighted toward facility-based evaluation-and-management services, with the Medicare ledger dominated by nursing-facility and inpatient follow-up codes (notably 99309, 99310, 99233) and supplemental home-visit (99349) and critical-care (99291) activity. Medicare lifetime revenue is $1.2M while Medicaid is $33.9K, indicating the clinical operations are oriented toward older or post-acute populations typically covered by Medicare rather than broad primary-care panels.
Revenue concentration on Medicare is extreme: the top three Medicare codes (99309, 99310, 99233) account for 69.4% of this provider’s total Medicare revenue, driven especially by 99309 which alone generates $584.5K (48.5% of Medicare revenue) from 8.5K claims. That level of dependence on a small set of nursing-facility and inpatient E/M codes suggests a business model focused on repeat, time-based visits in institutional settings.
On Medicaid the provider is even more concentrated: the top three Medicaid codes (99233, 99309, 99214) make up 87.9% of the provider’s total Medicaid revenue, with 99233 contributing $18.2K (53.7% of Medicaid revenue), 99309 $6.3K (18.6%), and 99214 $5.3K (15.6%). This indicates that the small Medicaid footprint ($33.9K lifetime revenue) follows the same post-acute and hospital follow-up service mix observed in Medicare.
National competitive standing on key Medicare codes is outsized: 99309 ranks #13 of 28092 providers nationally (100th percentile; extreme outlier) and 99310 ranks #75 of 12486 (99th percentile; extreme outlier), while 99233 ranks #1642 of 128818 (99th percentile; extreme outlier). Those ranks characterize the provider as a major national-volume outlier for nursing-facility subsequent care and high-volume inpatient follow-ups, rather than a typical community-level clinician for these codes.
By contrast, the provider’s Medicaid position within New Mexico is modest: 99233 ranks #65 of 93 providers in-state (30th percentile), 99309 ranks #42 of 56 (25th percentile), and 99214 ranks #881 of 963 (9th percentile). These in-state percentiles indicate the provider is a relatively minor Medicaid participant in the same service lines despite being a national outlier on Medicare volumes.
Operational throughput is substantial for the dominant Medicare codes, with 8.5K claims for 99309, 1.7K claims for 99310, and 1.1K claims for 99233 reported; this claim volume underpins the high Medicare revenue concentrations and signals frequent repeat encounters in nursing facilities and inpatient settings. The claim-level activity aligns with the time-based nature of many top codes (30–60+ minute visits), consistent with a practice model that prioritizes extended E/M encounters.
The practice offers ancillary procedural services supporting post-acute care and wound management in addition to E/M work: for example, 99349 (home visits) produced $51.8K in Medicare revenue and 11042 (debridement) generated $11.8K. These additional procedure and home-visit revenues complement the core SNF/inpatient mix and suggest bundled or on-site wound and home-care capabilities.
The provider’s NPI has been enumerated since 2016-03-31 (~10 years ago), indicating roughly a decade of measurable billing history; sustained high-volume billing on a small set of codes over that period suggests an established operational focus rather than a short-term or emergent coding pattern. Given the Medicare-dominant revenue mix ($1.2M Medicare vs $33.9K Medicaid), payer-concentration risk and negotiations with Medicare-focused contractors are likely the primary commercial levers for this provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
22 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 8,470 | $70 | $584.5K |
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 1,720 | $100 | $170.6K |
| 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… | 1,070 | $80 | $82.5K |
| 99349 | The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 690 | $80 | $51.8K |
| 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… | 360 | $140 | $51.6K |
| 99308 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider… | 1,040 | $50 | $50.9K |
| 99306 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least… | 390 | $120 | $44.9K |
| 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… | 550 | $80 | $44.3K |
| 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… | 360 | $110 | $38.2K |
| 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… | 640 | $50 | $33.3K |
Showing 1–10 of 22
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 140 | $140 | $18.2K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 70 | $90 | $6.3K |
| 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… | 40 | $150 | $5.3K |
| 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… | 20 | $210 | $4.1K |
How this provider's Medicaid billing volume and revenue compare to other New Mexico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Mexico median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 881 | 960 | 1,010 | $90 | $490K |
| 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… | 65 | 90 | 570 | $80 | $392.6K |
| 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… | 71 | 90 | 180 | $140 | $152.6K |
| 99309 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider… | 42 | 60 | 320 | $30 | $125.1K |
Other providers in the same ZIP code as Jaime Sanchez, ranked by combined Medicare and Medicaid revenue.
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