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

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

Carlos Ramos Saenz (NPI 1487030904)

Field	Value
Entity Type	Individual
Organization	Carlos Ramos Saenz
Address	7700 Floyd Curl Dr
City	San Antonio
State	TX
ZIP	78229
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 6, 2015

Payer Source	Total Paid
Medicare	$81.3K
Medicaid	$0

Key Findings

This provider's lifetime billings are effectively concentrated in Medicare: total Medicare revenue is $81.3K and there is no Medicaid billing on file. In practical terms the practice operates as a Medicare-focused billing entity rather than a mixed Medicaid/Medicare provider.

Revenue concentration is extreme: the precomputed top 3 Medicare codes by revenue account for 100.0% of this provider's total Medicare revenue, with the two reported codes representing the full mix (99223 at 82.7% and 99291 at 17.3%). This indicates almost all billing and payment flows through a very small set of high-acuity inpatient codes rather than a broader outpatient portfolio.

The code mix (99223 and 99291) points to inpatient and critical-care–oriented services rather than routine office-based primary care. 99223 is an initial hospital inpatient/observation E/M code for high-complexity encounters and 99291 is a critical care code for intensive, time-based management, so the practice appears to function as hospital-based internal medicine/critical care coverage rather than a clinic-centered practice.

Volume and payment detail reinforce that operational profile: 99223 shows 530 claims with $127 avg paid/claim and $67.3K revenue (82.7% of Medicare revenue), while 99291 shows 88 claims with $160 avg paid/claim and $14.1K revenue (17.3%). The claim counts and average allowed amounts show that revenue is driven by frequent high-complexity inpatient encounters rather than many low-acuity visits.

Competitive standing differs by code: for 99223 the provider ranks #581 of 139583 providers nationally (100th percentile; extreme outlier, far above typical national volume for this code), marking the provider as a national outlier or major participant for that specific inpatient admission code. By contrast, 99291 ranks #17589 of 71290 providers nationally (75th percentile; typical, unremarkable volume), indicating only a modest, expected presence among peers for critical care billing.

Because a single high-level inpatient E/M code (99223) accounts for the majority of Medicare revenue and is classified as an "extreme outlier," this billing pattern will strongly influence payer benchmarking and utilization profiles. Such concentration can simplify revenue forecasting but also means any changes in hospital privileges, admission patterns, or documentation expectations could have outsized effects on the provider's Medicare income.

The provider's NPI was enumerated on 2015-08-06 (~11 years ago), indicating an established enrollment history. Given the relatively modest lifetime Medicare revenue ($81.3K) despite enumeration for ~11 years, the data are consistent with a part-time hospital practice, limited Medicare-facing activity, or episodic hospital-based care rather than a high-volume outpatient practice.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	530	$130	$67.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	90	$160	$14.1K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Texas Distribution

Carlos Ramos Saenz — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	10	4,720	50	$160	$13.6K
99223	1	9,990	40	$130	$9.5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Carlos Ramos Saenz, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wesam Aziz	TX	Internal Medicine Physician	$665.5K	$0
Gopinath Chandrahasan	TX	Internal Medicine Physician	$571.6K	$0
William Morton	GA	Internal Medicine Physician	$479.3K	$0
Muhammad Syed	TX	Internal Medicine Physician	$208.6K	$153.3K
Rhonda Williams	GA	Internal Medicine Physician	$322.5K	$0
Lina Harper	GA	Family Medicine Physician	$250.4K	$0
John Sorrells	TX	Internal Medicine Physician	$221.6K	$0
Khris Ramdeen	ND	Internal Medicine Physician	$185.8K	$0
Chad Schneider	WI	Internal Medicine Physician	$183.9K	$0
Abdul Ftesi	OK	Hospitalist Physician	$183.6K	$0

Carlos Ramos Saenz — Billing Profile & Reimbursement Data

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Carlos Ramos Saenz — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References