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.

San Miguel Hospital Corporation (NPI 1396716643)

San Miguel Hospital Corporation is a general acute care hospital provider located in Las Vegas, New Mexico. This profile covers 0 Medicare and 157 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	San Miguel Hospital Corporation
Address	104 Legion Dr
City	Las Vegas
State	NM
ZIP	87701
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 26, 2006

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

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

157 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15,010	$200	$2.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	14,890	$150	$2.2M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	7,340	$260	$1.9M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,660	$150	$402.3K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	8,660	$50	$389.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	5,080	$70	$370.5K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	5,010	$70	$346K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,810	$190	$337.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	6,450	$50	$322.4K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	3,860	$80	$320.5K

Showing 1–10 of 157

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

San Miguel Hospital Corporation — 0 of 25 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

157 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	34	80	12,050	$160	$3.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	35	70	6,920	$210	$3.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	36	80	10,650	$130	$2.4M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	44	60	3,070	$210	$1.4M
G0378	Hospital observation service, per hour	25	40	1,000	$400	$1M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	29	60	2,820	$110	$799.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	20	50	7,300	$60	$737.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	30	80	3,340	$60	$595K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	21	40	7,150	$40	$485.3K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	21	50	4,450	$50	$422.6K

Showing 1–10 of 157

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Miguel Hospital Corporation	NM	Critical Access Hospital	$0	$3M
Michael Gurule	NM	Cardiovascular Disease Physician	$71.2K	$0
Robert Murray	FL	Certified Registered Nurse Anesthetist	$49.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Care, LLC.	NM	In Home Supportive Care Agency	$0	$52.8M
Victory Personal Care Inc.	NM	Home Health Agency	$0	$26.9M
Direct Healthcare	NM	In Home Supportive Care Agency	$0	$15.2M
Heritage Healthcare Of Northern New Mexico, Inc.	NM	Home Health Agency	$0	$14.8M
An Angels Touch LLC	NM	In Home Supportive Care Agency	$0	$13.4M
El Centro Family Health	NM	Federally Qualified Health Center (FQHC)	$0	$7.3M
Rainbow Road Therapies, Inc.	NM	Developmentally Disabled Services Day Training Agency	$0	$6.5M
State Of New Mexico	NM	Nursing Facility/Intermediate Care Facility	$0	$4.2M
Summit Emergency Medicine LLC	NM	Emergency Medicine Physician	$0	$3.1M
Jthink LLC	NM	Family Nurse Practitioner	$0	$2.6M

San Miguel Hospital Corporation — Billing Profile & Reimbursement Data

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San Miguel Hospital Corporation — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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