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    OpenPayerNPI Medicare & MedicaidRoy Avalos
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    Roy Avalos — Billing Profile & Reimbursement Data

    NPI 1154399632 · Encinitas, CA · Cardiovascular Disease Physician

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    Roy Avalos is a cardiovascular disease physician provider located in Encinitas, California. This profile covers 31 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationRoy Avalos
    Address320 Santa Fe Dr
    CityEncinitas
    StateCA
    ZIP92024
    TaxonomyCardiovascular Disease Physician
    NPI EnumeratedMarch 9, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$467.4K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    31 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    78452In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…270$390$104.5K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…490$140$66.8K
    93306The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…620$100$64.1K
    A9502Technetium tc-99m tetrofosmin, diagnostic, per study dose530$80$40K
    99233The 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…340$100$32.8K
    92928The provider inserts a catheter through the skin (percutaneous approach) and guides it into the heart's arteries. They deploy one or more stents (small tubes) to keep the artery open and may expand a…60$410$25.7K
    99214The 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…260$100$24.7K
    99223The 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…170$140$23.8K
    J2785Injection, regadenoson, 0.1 mg490$40$20.7K
    93229In 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…30$770$19.9K

    Showing 1–10 of 31

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 31 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    31 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9322923535040$890$468.8K
    933062942,400240$110$34.1K
    992332,50811,530120$100$26.2K
    9921410,96837,970120$90$23.2K
    78452741,19050$250$22.8K
    J2785166710220$40$18.8K
    9921550615,36050$130$14.4K
    929283237030$420$13.8K
    A950213240110$80$13.4K
    992231,44113,19050$140$11.3K

    Showing 1–10 of 31

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Roy Avalos, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Nikolas LondonCAOphthalmology Physician$6.4M$0
    Atul JainCAOphthalmology Physician$3.5M$0
    Walter NahmCADermatology Physician$3.1M$0
    Darren SigalCAMedical Oncology Physician$2.9M$0
    David GreeneCARadiation Oncology Physician$2.3M$119.1K
    Munveer BhangooCAMedical Oncology Physician$2.3M$0
    Caleb NgCARetina Specialist (Ophthalmology) Physician$2.2M$21K
    Iain MacewanCARadiation Oncology Physician$2.2M$0
    Anne HannekenCAOphthalmology Physician$2.1M$0
    Paul DatoCAUrology Physician$2M$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Arash Mozayan IsfahaniCAOphthalmology Physician$2.6M$0
    Alberto BessudoCAHematology & Oncology Physician$2M$0
    Natalie MacleanCARheumatology Physician$1.9M$0
    Ucsd Center For Surgery Of Encinitas, L.P.CAAmbulatory Surgical Clinic/Center$1.3M$0
    Laurie FrakesCAHematology & Oncology Physician$1.3M$0
    Katherine LudingtonCACardiovascular Disease Physician$1.2M$0
    Keven TagdiriCAInternal Medicine Physician$1M$51.3K
    Pingfeng DuCACardiovascular Disease Physician$769.2K$0
    Damian RaschCACardiovascular Disease Physician$680.1K$0
    James HowardCAGeneral Practice Physician$606.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. California Distribution
    Roy Avalos — 1 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California