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.

El Pueblo Health Services, Inc (NPI 1144302415)

Field	Value
Entity Type	Organization
Organization	El Pueblo Health Services, Inc
Address	121 Calle Del Presidente
City	Bernalillo
State	NM
ZIP	87004
Taxonomy	Family Nurse Practitioner
NPI Enumerated	October 19, 2006

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

44 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…	13,180	$120	$1.6M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	5,180	$150	$756.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3,900	$160	$631.6K
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,…	2,470	$120	$296.6K
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…	2,240	$120	$257K
99441	N/A	880	$160	$140.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	770	$180	$135.9K
99442	N/A	680	$160	$109K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	420	$170	$69.9K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	3,110	$20	$59.1K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

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

El Pueblo Health Services, Inc — 0 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
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…	92	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…	325	960	1,010	$90	$490K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	146	920	860	$120	$361.9K
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,…	47	380	220	$160	$273.9K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	52	380	400	$80	$213.5K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	111	290	470	$70	$161.5K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	97	110	610	$40	$148.2K
99203	The provider sees a new 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 provider…	141	360	220	$90	$134.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	96	150	660	$30	$123.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	85	140	170	$120	$114.6K

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with El Pueblo Health Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steven Hartman	NM	Family Medicine Physician	$11.4K	$0

Nearby Providers

Other providers in the same ZIP code as El Pueblo Health Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Always There Home Care LLC	NM	In Home Supportive Care Agency	$0	$33.4M
Valle Del Sol Of New Mexico, LLC	NM	Community/Behavioral Health Agency	$0	$7.7M
Abrazos Family Support Services	NM	Developmentally Disabled Services Day Training Agency	$0	$6.9M
Five Sandoval Indian Pueblos, Inc.	NM	Community/Behavioral Health Agency	$0	$3.2M
County Of Sandoval	NM	Ambulance	$148.7K	$2.2M
Walgreen Co	NM	Pharmacy	$155.4K	$0
Wal-mart Stores East LP	NM	Community/Retail Pharmacy	$91.4K	$0
Deidra Casaus	NM	Optometrist	$19.2K	$0
Robert Fontenot	NM	Optometrist	$11.7K	$0

El Pueblo Health Services, Inc — Billing Profile & Reimbursement Data

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El Pueblo Health Services, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References