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.

High Desert Pedicatrics PC (NPI 1437395332)

High Desert Pedicatrics PC is a pediatrics physician provider located in Albuquerque, New Mexico. This profile covers 0 Medicare and 51 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	High Desert Pedicatrics PC
Address	8650 Almeda Boulevard, Ne
City	Albuquerque
State	NM
ZIP	87122
Taxonomy	Pediatrics Physician
NPI Enumerated	December 23, 2008

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,250	$100	$600.3K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	12,010	$20	$276.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,510	$100	$255.8K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	3,830	$70	$249K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,360	$100	$240.8K
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…	2,080	$80	$172.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,490	$100	$153.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	460	$100	$47.8K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,020	$20	$45.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	930	$20	$18.6K

Showing 1–10 of 51

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

High Desert Pedicatrics PC — 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

51 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…	327	930	910	$80	$521.6K
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…	153	960	1,010	$90	$490K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	31	100	1,100	$110	$362K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	31	120	670	$110	$301.2K
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,…	270	380	220	$160	$273.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	30	120	430	$110	$205.4K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	26	110	610	$40	$148.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	15	150	660	$30	$123.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	44	140	170	$120	$114.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	23	70	170	$30	$97.7K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lisa Sisneros Brow, Speech-language Pathologist, LLC	NM	Speech-Language Pathologist	$0	$6.2M
Balanced Physical Therapy And Wellness, LLC	NM	Physical Therapy Clinic/Center	$0	$1.8M
Cyd Evans	NM	Contractor	$0	$1.4M
Physician Surgery Center Of Albuquerque LLC	NM	Ambulatory Surgical Clinic/Center	$541.3K	$56.4K
Diego Gonzalez	NM	Interventional Pain Medicine Physician	$189.6K	$29.2K
Dennis Garcia	NM	Family Medicine Physician	$110.4K	$0
Cvs Pharmacy, Inc.	NM	Pharmacy	$91.9K	$0
Tomas Tafoya	NM	Orthopedic Physical Therapist	$71.6K	$0
Gerard Kerbleski	NM	Foot & Ankle Surgery Podiatrist	$64.3K	$0
Shanti Balkissoon-castillo	NM	Foot & Ankle Surgery Podiatrist	$63K	$0

High Desert Pedicatrics PC — Billing Profile & Reimbursement Data

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High Desert Pedicatrics PC — 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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