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.

Roswell Hospital Corporation (NPI 1447221742)

Key Findings

Field	Value
Entity Type	Organization
Organization	Roswell Hospital Corporation
Address	405 W Country Club Rd
City	Roswell
State	NM
ZIP	88201
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 27, 2006

Payer Source	Total Paid
Medicaid	$41.3M
Medicare	$0

This provider has no Medicare billing on file and reports $41.3M in lifetime Medicaid revenue, so the available record is effectively single-payer (Medicaid) in scope for analytic comparisons. Analysts should treat national Medicare benchmarking as not applicable for this entity given the absence of Medicare claims.

Revenue is highly concentrated in a small set of Medicaid codes: the dataset notes that the top 3 Medicaid codes account for 42.4% of total Medicaid revenue. The top three contributors are 99284 ($5.8M, 18.6%), 99283 ($5.6M, 18.0%), and 43239 ($1.8M, 5.8%), indicating a small number of services drive a large share of the hospital’s Medicaid receipts.

Operationally the code mix points to an emergency-department-centered acute-care operation with complementary procedural and imaging capacity. High claim volumes for ED E/M codes (99284 at 32.8K claims and 99283 at 36.9K claims) combined with meaningful volumes for endoscopy (43239, 5.2K claims) and CT imaging (74177, 74176, 70450) suggest the hospital manages high ED throughput and on‑site diagnostic/procedural services.

State-level competitive standing for core ED activity is mixed: 99283 ranks #12 of 84 in-state (87th percentile) and 99284 ranks #17 of 76 (79th percentile), both characterized in the dataset as "typical, unremarkable volume" despite being above median among peers. The highest-acuity ED code 99285 is closer to the middle of the peer set (rank #37 of 71, 49th percentile), indicating relatively fewer very-high-acuity ED visits compared with some in-state competitors.

There are identifiable procedural strengths beyond the ED: upper endoscopy and colonoscopy services show above-median to high standing (43239 rank #6 of 53, 90th percentile; 45378 rank #3 of 29, 93th percentile and labeled as notably above typical). These rankings and the associated payments (e.g., 45378 with $687.7K revenue, 43239 with $1.8M) indicate the hospital is a meaningful regional provider for GI diagnostic and therapeutic procedures.

Laboratory and imaging panels are also significant revenue contributors, but generally sit at typical state volumes. High-volume lab codes like 80053 (56.9K claims, $1.4M revenue, 91th percentile) and 85025 (59.2K claims, $769.4K revenue, 93th percentile) plus multiple CT and radiology codes (e.g., 74177, 70450) reflect standard inpatient and ED diagnostic throughput rather than outlier specialty concentration.

A small set of codes are flagged as statistical outliers in the dataset and warrant attention: 45378 and 96372 are explicitly described as "notably above typical" statewide volume, and 96372 ranks #7 of 241 providers (98th percentile). Those labels suggest relative specialization or higher intensity billing for certain injections and colonoscopy-related services compared with in-state peers.

The provider has long tenure in the NPI registry (enumerated 2006-01-27, ~20 years ago), which supports interpreting its pattern as an established hospital practice rather than a short-term anomaly. The combination of long enumeration, dominant Medicaid receipts, and concentrated ED/procedural revenue should guide any market-entry or competitive analyses focused on Medicaid-managed care relationships and regional GI/ED capacity.

Medicaid: Complete Services Breakdown

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

310 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.	32,780	$180	$5.8M
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.	36,900	$150	$5.6M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	5,170	$350	$1.8M
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.	3,680	$440	$1.6M
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.	5,100	$280	$1.4M
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.	56,910	$20	$1.4M
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.	6,590	$210	$1.4M
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.	6,700	$200	$1.3M
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…	17,360	$60	$989.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	2,850	$340	$959.8K

Showing 1–10 of 310

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

Roswell Hospital Corporation — 2 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

310 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.	17	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.	37	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	33	40	3,670	$80	$3.2M
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.	12	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.	21	60	3,070	$210	$1.4M
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	3	10	570	$80	$1M
G0378	Hospital observation service, per hour	11	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.	13	60	2,820	$110	$799.5K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	22	30	380	$100	$796.5K
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…	10	50	7,300	$60	$737.6K

Showing 1–10 of 310

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roswell Clinic Corp	NM	Family Medicine Physician	$0	$14.7M
Fundador Adajar	NM	Cardiovascular Disease Physician	$317.9K	$0
Hamid Feroze	NM	Cardiovascular Disease Physician	$242.9K	$0
Brandon Cometti	NM	Family Medicine Physician	$207.8K	$0
Thomas Wulf	NM	Family Medicine Physician	$196.4K	$0
Robert Schwartz	NM	Orthopaedic Surgery Physician	$140.7K	$0
Virgle Herrin	NM	General Practice Physician	$121.8K	$0
Omar Osmani	NM	Orthopaedic Surgery Physician	$120.4K	$0
Daniel Ridout	NM	Gastroenterology Physician	$108.6K	$0
Richard Pinon	NM	Family Medicine Physician	$108.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aspire Developmental Services, LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$45.5M
Bca Medical Associates, PA	NM	Pediatrics Physician	$0	$41.2M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$20.1M
Pathology Consultants Of New Mexico	NM	Anatomic Pathology Physician	$376.7K	$18M
La Casa De Buena Salud Inc	NM	Federally Qualified Health Center (FQHC)	$0	$11M
Masoud Khorsand- Sahbaie Md P A	NM	Hematology & Oncology Physician	$0	$8.1M
Agape Home Care LLC	NM	Supports Brokerage Agency	$0	$7.4M
Roswell Family Care, LLC	NM	Family Nurse Practitioner	$0	$6.3M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$6M
Familia Dental Ros LLC	NM	Dental Clinic/Center	$0	$5.6M

Roswell Hospital Corporation — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References