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.

Cibola General Hospital Corporation (NPI 1457675266)

Cibola General Hospital Corporation is a rural health clinic/center provider located in Grants, New Mexico. This profile covers 0 Medicare and 63 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	Cibola General Hospital Corporation
Address	1423 E Roosevelt Ave
City	Grants
State	NM
ZIP	87020
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 23, 2010

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

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

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	21,850	$130	$2.9M
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…	6,370	$150	$981.1K
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,…	3,730	$150	$541K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	4,630	$60	$259.2K
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…	1,800	$110	$200.2K
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…	1,200	$150	$181.7K
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…	1,400	$120	$167.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,620	$30	$151.6K
99203	The provider sees a new 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 provider…	820	$150	$125.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	730	$150	$111.3K

Showing 1–10 of 63

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

Cibola General Hospital Corporation — 1 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

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	11	20	6,090	$180	$7.2M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	49	140	130	$220	$568.5K
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…	54	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…	149	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…	42	100	1,100	$110	$362K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	923	920	860	$120	$361.9K
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…	46	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,…	30	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.	48	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…	63	110	610	$40	$148.2K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cibola General Hospital Corporation	NM	Critical Access Hospital	$0	$26.5M
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Mrunal Tailor	NM	Diagnostic Radiology Physician	$897.5K	$0
Masoud Shiehmorteza	NM	Diagnostic Radiology Physician	$773.7K	$0
Aaron Losey	NM	Diagnostic Radiology Physician	$518K	$0
Jason Ross	TX	Diagnostic Radiology Physician	$482.4K	$0
Tiffany Lewis	NM	Diagnostic Radiology Physician	$402K	$3.3K
Rachel Nelson	TN	Diagnostic Radiology Physician	$383.2K	$0
Lauren Mccullough	NM	Diagnostic Radiology Physician	$363.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Silver Lining Services, LLC	NM	Home Health Agency	$0	$31.9M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$10.3M
Fedko Emergency Physicians New Mexico LLC	NM	Emergency Medicine Physician	$0	$7.2M
Las Brisas Enterprises, LLC	NM	Dental Clinic/Center	$0	$4.6M
Dialysis Clinic Inc.	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.7M
Michael Rohde	NM	Physical Therapist	$135.1K	$0
Amy Yates	NM	Occupational Therapist	$23.7K	$0

Cibola General 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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