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 Nevada for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Nevada 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. Nevada (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.

Iriye Medical Group PLLC (NPI 1467496240)

Iriye Medical Group PLLC is a maternal & fetal medicine physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 44 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	Iriye Medical Group PLLC
Address	2011 Pinto Lane
City	Las Vegas
State	NV
ZIP	89106
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicaid	$11.9M
Medicare	$0

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	31,730	$130	$4.1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	20,880	$120	$2.5M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	10,140	$180	$1.8M
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	13,900	$90	$1.3M
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	5,140	$120	$616.6K
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…	4,980	$110	$542.5K
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…	6,580	$60	$414.3K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	3,050	$40	$125.2K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	5,260	$20	$115.6K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	1,270	$50	$61K

Showing 1–10 of 44

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.

Claims Volume vs. Nevada Distribution

Iriye Medical Group PLLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	2	30	410	$110	$350.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	316	470	380	$70	$281.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	188	430	500	$40	$214.4K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2	20	110	$160	$199.9K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	2	10	30	$230	$152.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1	50	230	$110	$144.9K
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…	205	2,250	290	$60	$138K
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…	186	2,480	330	$50	$107.6K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	59	120	140	$80	$82.9K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	2	70	340	$60	$78.9K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Donna Miller	NV	Obstetrics & Gynecology Physician	$15.4K	$239.5K
Sarah Newton	NV	Obstetrics & Gynecology Physician	$32K	$43.8K
Amy Falcone-wharton	NV	Obstetrics & Gynecology Physician	$19.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clark County Department Of Family Services	NV	Case Management Agency	$0	$166.5M
Shadow Emergency Physicians PLLC	NV	Emergency Medicine Physician	$0	$75.2M
Valley Hospital Medical Center	NV	General Acute Care Hospital	$0	$47M
Southwest Medical Associates, Inc	NV	Diagnostic Radiology Physician	$418.3K	$15.8M
Las Vegas Paiute Tribe Health & Human Services	NV	General Practice Physician	$0	$13.6M
Fresenius Medical Care West Sahara, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.2M
Bridge Counseling Associates, Inc	NV	Community/Behavioral Health Agency	$0	$12.1M
Janda, Mahajan & Balsiger PLLC	NV	Neurology Physician	$0	$10.5M
Behavioral Health Institute Inc (singh) PC	NV	Addiction Medicine (Family Medicine) Physician	$0	$9.8M
Pulmonary Associates, Inc.	NV	Pulmonary Disease Physician	$0	$8.5M

Iriye Medical Group PLLC — Billing Profile & Reimbursement Data

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Iriye Medical Group PLLC — 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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