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.

Lisa Martinez (NPI 1215345772)

Field	Value
Entity Type	Individual
Organization	Lisa Martinez
Address	6100 Pan American Freeway Ne Ste 200
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Family Medicine Physician
NPI Enumerated	July 29, 2014

Payer Source	Total Paid
Medicare	$7.2K
Medicaid	$0

Key Findings

This provider reported $7.2K in total Medicare revenue and none (no Medicaid billing on file) for Medicaid, making their Medicare business effectively single-payer in scope based on available claims data. The absence of any Medicaid billing on file indicates analysts should treat this profile as a Medicare-focused billing footprint rather than a mixed payer practice.

Revenue for this provider is extremely concentrated: the precomputed top three Medicare codes — 99215 (61.1%), G0439 (20.3%), and 99214 (18.5%) — account for 100.0% of this provider's total Medicare revenue. That concentration shows nearly all reported Medicare dollars are tied to a small bundle of office-based evaluation/management and annual wellness visit services.

The code mix (99215, 99214, and G0439) points to a traditional family medicine outpatient practice model focused on established-patient E/M visits and preventive Annual Wellness Visits rather than procedure-based specialties. 99215 activity (50 claims, $88 avg paid/claim, $4.4K revenue) and 99214 activity (23 claims, $58 avg paid/claim, $1.3K revenue) together reflect higher-acuity and moderate-acuity established-patient visits, while G0439 (12 claims, $122 avg paid/claim, $1.5K revenue) represents preventive care encounters.

99215 is the largest single revenue driver for this provider (50 claims, $4.4K revenue, 61.1% of Medicare revenue) and ranks #58000 of 145531 providers nationally (59th percentile; typical, unremarkable volume for this code), indicating a modest, broadly typical level of national engagement for high-complexity E/M visits rather than market dominance. This ranking suggests the provider participates at a routine level for 99215 relative to national peers.

G0439 (Annual Wellness Visit) generates $1.5K and 20.3% of Medicare revenue but ranks #101774 of 105855 providers nationally (2th percentile; typical, unremarkable volume for this code), signaling comparatively low AWV volume versus peers despite its proportional contribution to this small Medicare revenue base. The low national rank combined with its share of the provider's revenue implies AWVs are a material part of the limited Medicare billing but not delivered at volumes that stand out regionally or nationally.

99214 accounts for $1.3K and 18.5% of Medicare revenue (23 claims) and ranks #420734 of 479517 providers nationally (11th percentile; typical, unremarkable volume for this code), which places the provider at a lower-than-average national volume for moderate-complexity established-patient visits. Together with the 99215 ranking, the pattern is of routine primary care E/M services at modest scale.

The provider's NPI was enumerated on 2014-07-29 (~12 years ago), so enrollment in Medicare is longstanding even though reported Medicare revenue is small; this tenure suggests the limited billing is not due to a recent enrollment. Given the combination of long enrollment and low reported Medicare receipts, plausible explanations include a small Medicare panel, part-time clinical activity, billing under another group NPI, or non-Medicare-focused practice activities, all of which would merit verification in payer/provider records.

Operationally, the practice shows a narrow revenue base (100.0% of Medicare revenue concentrated in 99215, G0439, and 99214) and a low overall Medicare dollar volume ($7.2K), which implies revenue fragility to shifts in E/M reimbursement or patient mix. For competitive analysis, this provider should be viewed as a modest, local-scale Medicare participant rather than a dominant regional player; any benchmarking or network decisions should account for both the small absolute revenue and the concentrated service mix.

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The 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…	50	$90	$4.4K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	10	$120	$1.5K
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…	20	$60	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Lisa Martinez — 0 of 3 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. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	15	2,700	90	$70	$12.9K
G0439	3	490	50	$120	$9.7K
99215	2	960	40	$110	$7.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duke University Affiliated Physicians, Inc.	NC	Emergency Medicine Physician	$0	$11.6M
Anuj Prasad	PA	Internal Medicine Physician	$113.8K	$0
Paul Hankenson	MI	Family Medicine Physician	$73.6K	$0
Shyam Balakrishnan	VA	Family Medicine Physician	$53.8K	$7.9K
Boris Getman	WV	Family Medicine Physician	$50.5K	$0
Jillian Wilford	WV	Family Medicine Physician	$19.3K	$29.6K
Michael Matela	WV	Family Medicine Physician	$25.5K	$19.5K
Joseph Benjamin	IA	Family Medicine Physician	$43.3K	$0
Racheal Tushabe	SD	Internal Medicine Physician	$37.8K	$0
Beverly Huang	VA	Family Medicine Physician	$37.3K	$0

Lisa Martinez — Billing Profile & Reimbursement Data

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Lisa Martinez — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References