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.

Andrea Sandoval (NPI 1386088391)

Field	Value
Entity Type	Individual
Organization	Andrea Sandoval
Address	Internal Medicine Msc10 5550
City	Albuquerque
State	NM
ZIP	87131
Taxonomy	Anesthesiology Physician
NPI Enumerated	April 20, 2013

Payer Source	Total Paid
Medicare	$5K
Medicaid	$0

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
01810	The provider performs anesthesia services for a patient undergoing any procedures on the nerves, muscles, tendons, fascia, and bursae of the forearm, wrist, and hand.	40	$50	$1.9K
01830	The provider performs anesthesia services for a patient undergoing procedures on the distal radius, distal ulna, wrist, or hand joints. The provider may perform the procedure by using an open…	20	$80	$1.4K
00142	The provider performs anesthesia services for a patient undergoing an eye lens procedure.	10	$80	$1.1K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	30	$20	$650

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Mexico Distribution

Andrea Sandoval — 1 of 4 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

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
00142	77	80	60	$80	$11.8K
01830	2	10	10	$100	$1.5K
01810	1	30	10	$80	$1.3K
76942	25	80	20	$40	$1.3K

Andrea Sandoval — Billing Profile & Reimbursement Data

Sign up for Andrea Sandoval — Billing Profile & Reimbursement Data policy alerts

Andrea Sandoval — Billing Profile & Reimbursement Data

Sign up for Andrea Sandoval — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References