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NPI 1336171040 · Jackson Heights, NY · Pulmonary Disease Physician
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Sergio Martinez is a pulmonary disease physician provider located in Jackson Heights, New York. This profile covers 16 Medicare and 66 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Sergio Martinez |
| Address | 3711 88th St |
| City | Jackson Heights |
| State | NY |
| ZIP | 11372 |
| Taxonomy | Pulmonary Disease Physician |
| NPI Enumerated | July 6, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $464.3K |
| Medicare | $103.5K |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 570 | $70 | $40.1K |
| 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… | 210 | $70 | $14.6K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 120 | $110 | $13.9K |
| 99305 | The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least… | 80 | $100 | $8.2K |
| 94621 | The provider performs complex cardiopulmonary exercise testing (CPET) to evaluate the heart and lung function. The procedure includes measuring minute ventilation (the volume of gas exhaled). Minute… | 60 | $130 | $8.1K |
| 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… | 70 | $50 | $3.1K |
| 94729 | In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream. | 60 | $50 | $3K |
| 94726 | The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may… | 60 | $50 | $2.9K |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 20 | $190 | $2.9K |
| 94060 | The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is… | 60 | $30 | $2K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99308 | 2,287 | 2,360 | 250 | $60 | $44.9K |
| 99214 | 28,878 | 30,450 | 90 | $100 | $19K |
| 99305 | 371 | 940 | 60 | $110 | $16.9K |
| 99232 | 825 | 11,850 | 80 | $70 | $13.8K |
| 99213 | 7,272 | 31,440 | 80 | $70 | $12.1K |
| 99222 | 626 | 7,870 | 30 | $110 | $5.9K |
| 94621 | 10 | 40 | 40 | $110 | $5.6K |
| G0438 | 690 | 1,150 | 20 | $170 | $4.9K |
| 94729 | 343 | 680 | 70 | $40 | $4.8K |
| 99203 | 8,461 | 11,360 | 30 | $90 | $4.7K |
Showing 1–10 of 16
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
66 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… | 7,780 | $30 | $225.7K |
| 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… | 1,250 | $50 | $59.9K |
| 95004 | The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient. | 230 | $170 | $38.3K |
| 99397 | The provider performs an established well–patient visit for a patient who is 65 years or older. | 2,300 | $20 | $36.8K |
| 99401 | At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects… | 7,360 | $1 | $22.1K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 300 | $60 | $17.6K |
| 99396 | The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64. | 430 | $40 | $15.6K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 220 | $70 | $14.4K |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 2,800 | $1 | $8.4K |
| 97802 | The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the… | 4,110 | $1 | $4.1K |
Showing 1–10 of 66
How this provider's Medicaid billing volume and revenue compare to other New York providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New York median
66 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… | 1,817 | 19,110 | 360 | $70 | $321K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 383 | 590 | 1,160 | $20 | $277.2K |
| 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… | 3,522 | 16,550 | 220 | $90 | $186.8K |
| 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,… | 4,489 | 5,420 | 210 | $70 | $154.3K |
| 95004 | The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient. | 177 | 410 | 150 | $190 | $151.6K |
| 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… | 2,503 | 4,700 | 130 | $100 | $136.6K |
| 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… | 2,066 | 3,820 | 100 | $130 | $99.7K |
| 99396 | The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64. | 740 | 2,010 | 200 | $90 | $81.7K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 332 | 570 | 470 | $10 | $80.8K |
| 99395 | The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39. | 1,613 | 1,880 | 170 | $80 | $69K |
Showing 1–10 of 66
Other providers in the same ZIP code as Sergio Martinez, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Bangla Cdpap Services, Inc | NY | Home Health Agency | $0 | $80M |
| Shopno 1, LLC | NY | Home Health Aide | $0 | $55.8M |
| Mark R LLC | NY | Adult Care Home Facility | $0 | $47.8M |
| Bengal Home Care Inc. | NY | Home Health Agency | $0 | $42.1M |
| Mental Health Providers Of Western Queens, Inc. | NY | Adult Mental Health Clinic/Center | $0 | $33.9M |
| Jacqueline Dauhajre | NY | Ophthalmology Physician | $94.7K | $981.6K |
| Kelvin Ogelle | NY | Primary Podiatric Medicine Podiatrist | $709.6K | $192K |
| Nidhi Dugar | NY | Internal Medicine Physician | $471.6K | $1.1K |
| Alyssa Mariz Liwanag | NY | Occupational Therapist | $345.4K | $39.5K |
| Mayra Mahadin | NY | Specialist | $29.4K | $332.2K |
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