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

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

Carlos Jimenez (NPI 1336247204)

Carlos Jimenez is a pulmonary disease physician provider located in Houston, Texas. This profile covers 19 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.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Carlos Jimenez
Address	1515 Holcombe Blvd
City	Houston
State	TX
ZIP	77030
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicare	$53.5K
Medicaid	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99205	The provider sees a new 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 provider…	70	$140	$9.5K
31653	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	50	$190	$9.3K
31652	The provider inserts a rigid or flexible lighted tubular instrument (endoscope) into the patient's lungs, with or without the aid of fluoroscopy, live X–ray images on a video display. The provider…	30	$160	$4.6K
31629	The provider uses a diagnostic rigid or flexible bronchoscope to obtain one or more biopsies from the trachea, main stem, and/or lobar bronchus using a transbronchial needle aspiration technique.	40	$110	$4.3K
31627	In this add–on procedure, the provider uses previously taken CT or MRI images integrated with specialized software to facilitate bronchoscopy.	40	$70	$3.3K
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…	30	$110	$3.1K
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…	30	$100	$2.6K
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…	270	$10	$2.4K
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…	20	$110	$2.1K
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.	280	$10	$2K

Showing 1–10 of 19

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	30,070	32,500	110	$80	$17.6K
99215	6,532	8,730	40	$120	$9.2K
99204	9,023	16,380	30	$110	$5.6K
99205	467	4,320	30	$150	$5.5K
99222	4,449	7,910	30	$100	$4.9K
31653	1	20	20	$180	$3.7K
94729	47	570	70	$30	$3.2K
31652	9	40	20	$150	$3.2K
94726	39	460	70	$30	$3.1K
32555	188	320	20	$80	$2.8K

Carlos Jimenez — Billing Profile & Reimbursement Data

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Carlos Jimenez — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References