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.

Rafael Avila (NPI 1134176837)

Field	Value
Entity Type	Individual
Organization	Rafael Avila
Address	1022 E Griffin Pkwy Ste 110
City	Mission
State	TX
ZIP	78572
Taxonomy	Plastic Surgery Physician
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicare	$20K
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
14060	The provider replaces the lesions in the eyelids, nose, ears, or lips, with the healthy tissues from an adjacent site. This code represents a defect of 10 cm2 or less.	20	$490	$10.3K
11641	The provider excises a cancerous (malignant) lesion, including margins, of 0.6 to 1.0 cm in diameter, from the skin of the face, ears, eyelids, nose, lips.	20	$160	$3.1K
11642	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the face, ears, eyelids, nose, lips.	20	$210	$3.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	50	$50	$2.3K
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,…	30	$40	$1.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Rafael Avila — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
14060	72	120	20	$560	$18.3K
11642	62	80	20	$110	$3.6K
99212	2,692	5,510	30	$40	$2.2K
11641	5	20	10	$110	$2.1K
99202	186	1,220	20	$40	$1.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alegre Home Health Care LLC	TX	Home Health Agency	$0	$146.2M
Truemed Homecare Inc	TX	Personal Care Attendant	$0	$42.2M
South Texas Personal Care Service Inc.	TX	Personal Care Attendant	$0	$38.2M
Angelitos Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$35.2M
Un Buen Amanecer Home Health, Inc.	TX	Personal Care Attendant	$0	$27.3M
M & G Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$26.2M
Amigos Y Familia Primary Home Care	TX	Personal Care Attendant	$0	$22.9M
Dogwood Home Health Care, LLC	TX	Home Health Agency	$0	$22.3M
Saint Michael's Primary Health Care,llc.	TX	Personal Care Attendant	$0	$17.8M
Nuestra Esperanza Primary Home Care, LLC	TX	Personal Care Attendant	$0	$17.3M

Rafael Avila — Billing Profile & Reimbursement Data

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Rafael Avila — 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