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 Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado 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. Colorado (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.

Hall Medical, LLC (NPI 1164724274)

Hall Medical, LLC is a family medicine physician provider located in Lakewood, Colorado. This profile covers 0 Medicare and 27 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Hall Medical, LLC
Address	3190 S Wadsworth Blvd Ste 250
City	Lakewood
State	CO
ZIP	80227
Taxonomy	Family Medicine Physician
NPI Enumerated	November 22, 2010

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	12,820	$90	$1.1M
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…	15,060	$60	$888.3K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	2,170	$220	$486.3K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	14,100	$30	$394.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	16,000	$10	$224K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	600	$150	$88.8K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	600	$110	$67.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	330	$100	$34.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,690	$20	$32.2K
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,…	610	$40	$22.6K

Showing 1–10 of 27

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Hall Medical, LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

27 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…	128	2,520	330	$100	$352K
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…	144	2,630	430	$90	$268.2K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	5	30	330	$160	$168.4K
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,…	157	690	140	$90	$118.4K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	16	50	210	$100	$66.2K
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…	335	880	110	$80	$64.9K
99204	The provider sees a new 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 provider…	401	990	90	$120	$57.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	22	50	1,760	$10	$54.4K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	1	80	260	$30	$25.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	19	130	50	$100	$20.1K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Spectra Human Services, Inc.	CO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$94M
Rocky Mountain Medical Equipment, Inc.	CO	Oxygen Equipment & Supplies (DME)	$0	$26.9M
Integrated Life Choices	CO	Developmentally Disabled Services Day Training Agency	$0	$16.3M
Rocky Mountain Gastroenterology Associates, PLLC	CO	Gastroenterology Physician	$0	$3.7M
David Hurt	CO	Dermatology Physician	$285.5K	$0
Michaela Mcdonnell	CO	Dermatology Physician	$188.3K	$0
Kelly Richardson	CO	Family Nurse Practitioner	$77.3K	$0
Kyle Odvody	CO	Family Nurse Practitioner	$68.2K	$0
Mary Brady	CO	MOHS-Micrographic Surgery Physician	$59.3K	$0
Christian Jones	CO	Physical Therapist	$24.2K	$0

Hall Medical, LLC — Billing Profile & Reimbursement Data

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Hall Medical, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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