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.

Sheridan Children Healthcare Services Of New Mexico Inc (NPI 1245213750)

Field	Value
Entity Type	Organization
Organization	Sheridan Children Healthcare Services Of New Mexico Inc
Address	4701 Montgomery Blvd Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	November 29, 2005

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	6,420	$110	$693.1K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	4,630	$110	$504.3K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1,440	$320	$458.1K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	3,890	$70	$280.1K
92650	In this procedure, the provider measures the patient’s response to sound stimuli to screen auditory potential (electrical response). The screening uses frequency nonspecific stimuli and automated…	3,660	$70	$259.7K
92586	N/A	4,050	$60	$251.2K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2,540	$90	$223.9K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,490	$60	$92.3K
54150	The provider performs a circumcision, a surgical procedure that removes the foreskin of the penis, using a clamp or other device and regional anesthesia consisting of a dorsal penile or ring block.	1,010	$90	$88K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	1,140	$30	$38.8K

Showing 1–10 of 14

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

Sheridan Children Healthcare Services Of New Mexico Inc — 4 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	4	10	4,270	$400	$1.7M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	3	10	6,420	$120	$1.1M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	10	5,500	$120	$1M
92650	In this procedure, the provider measures the patient’s response to sound stimuli to screen auditory potential (electrical response). The screening uses frequency nonspecific stimuli and automated…	3	10	3,660	$90	$420.4K
92586	N/A	2	10	2,300	$70	$336.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	9	60	140	$80	$127.1K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	2	10	30	$90	$82.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	16	70	240	$70	$71.1K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	2	30	120	$80	$65.9K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	41	50	170	$30	$46.4K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Sheridan Children Healthcare Services Of New Mexico Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M

Sheridan Children Healthcare Services Of New Mexico Inc — Billing Profile & Reimbursement Data

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Sheridan Children Healthcare Services Of New Mexico 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

Nearby Providers

Frequently Asked Questions

References