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.

Dhhs Phs Naihs Crownpoint Hospital (NPI 1114960093)

Key Findings

Field	Value
Entity Type	Organization
Organization	Dhhs Phs Naihs Crownpoint Hospital
Address	Junction Of Hwy 371
City	Crownpoint
State	NM
ZIP	87313
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$35.3M
Medicare	$0

This provider is effectively single‑payer in the claims record: Medicare billing is none below while total Medicaid revenue is $35.3M, and the NPI was enumerated 2006-06-14 (~20 years ago) under the taxonomy General Acute Care Hospital. That tenure indicates a long-standing enrollment, but the active revenue stream on file is concentrated entirely in Medicaid.

Revenue is extremely concentrated in a single code group: the precomputed top 3 Medicaid codes by revenue account for 87.7% of this provider's total Medicaid revenue, with Q3014 alone representing $28.6M revenue (81.0% of this provider's total Medicaid revenue). This degree of concentration shows most economic activity documented here is driven by a very small set of codes.

The code mix points to a facility role as an originating site for telehealth: Q3014 (Telehealth originating site facility fee) is the dominant payer code by far, and the presence of outpatient E/M codes such as 99213 and 99211 alongside Q3014 suggests the hospital bills both facility telehealth fees and typical outpatient encounter services. Together these codes imply the organization operates as a local site enabling telehealth visits while also delivering standard outpatient care.

DHHS PHS NAIHS CROWNPOINT HOSPITAL is a statewide outlier on telehealth facility billing: Q3014 ranks #1 of 179 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), indicating this provider is the dominant source of originating‑site telehealth facility revenue in New Mexico. That ranking signals a unique local market position for this specific service line.

By contrast, the provider’s other top Medicaid codes are high but not dominant: 99213 has 13.7K claims and $1.5M revenue (4.4% of this provider's total Medicaid revenue) and ranks #90 of 932 in-state (90th percentile; typical, unremarkable volume), while 0001A has 1.6K claims and $799.7K revenue (2.3% of this provider's total Medicaid revenue) and ranks #7 of 71 in-state (91th percentile; typical, unremarkable volume). These ranks show strong relative activity for those codes but nowhere near the outsized concentration of Q3014.

The billing profile carries notable operational and reimbursement sensitivity: with $28.6M (81.0%) of Medicaid dollars tied to Q3014, changes to telehealth originating‑site payment policies, audit focus, or patient routing could materially alter revenue. Analysts and contracting teams should treat telehealth facility fee policy risk and state Medicaid reimbursement rules as primary drivers of the provider’s financial outlook.

The dataset includes several pandemic‑era and procedure codes that reflect episodic public‑health activity—87635 (SARS–CoV–2 NAAT) appears with $711.5K revenue and 90480 (COVID‑19 vaccine administration) with $40.6K revenue—indicating the provider also billed testing and vaccination services alongside routine outpatient care. Additionally, multiple top entries are listed with no description available (e.g., 0001A, 0002A, 0003A), which suggests use of specialty or newer administrative codes that should be cross‑checked against state program guidance during review.

Taken together, the profile indicates a General Acute Care Hospital with ~20 years of enrollment that functions in Medicaid primarily as an originating telehealth site and outpatient care provider. The provider’s competitive standing is highly concentrated on one service line (telehealth originating site) where it is a statewide leader, while other service lines show typical or above‑average in‑state activity but much smaller revenue contributions.

Medicaid: Competitive Analysis & Benchmarks

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q3014	Telehealth originating site facility fee	49,100	$580	$28.6M
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…	13,710	$110	$1.5M
0001A	N/A	1,570	$510	$799.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,850	$390	$714.8K
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…	1,340	$530	$711.5K
0002A	N/A	1,340	$520	$691.7K
0011A	N/A	580	$510	$293K
0003A	N/A	500	$510	$251K
0012A	N/A	480	$510	$247.8K
0071A	N/A	430	$550	$234.8K

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

Claims Volume vs. New Mexico Distribution

Dhhs Phs Naihs Crownpoint Hospital — 2 of 25 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. New Mexico median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	65	80	10,650	$130	$2.4M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	19	140	130	$220	$568.5K
Q3014	Telehealth originating site facility fee	1	180	620	$160	$546.7K
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…	90	930	910	$80	$521.6K
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…	701	960	1,010	$90	$490K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	38	60	1,990	$90	$406.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	288	290	2,790	$50	$325.7K
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,…	162	380	220	$160	$273.9K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	113	140	630	$80	$236.9K
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…	26	110	220	$70	$139.3K

Showing 1–10 of 44

Dhhs Phs Naihs Crownpoint Hospital — Billing Profile & Reimbursement Data

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Dhhs Phs Naihs Crownpoint Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References