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.

Apex Medical Center (NPI 1487716304)

Apex Medical Center is a internal medicine physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 60 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	Apex Medical Center
Address	1701 Wellness Way Ste 200
City	Las Vegas
State	NV
ZIP	89106
Taxonomy	Internal Medicine Physician
NPI Enumerated	December 15, 2006

Payer Source	Total Paid
Medicaid	$7.2M
Medicare	$0

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

60 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…	74,450	$60	$4.2M
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…	25,930	$40	$1.1M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	26,960	$30	$700.9K
77002	The provider uses fluoroscopic guidance to place a needle for biopsy, aspiration, injection, or localization of a device to detect any lesions in any area of the body, except for the spine, or to…	4,220	$60	$265.6K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	3,410	$50	$156.9K
99205	The provider sees a new 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 provider…	990	$140	$142.4K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	3,520	$30	$102.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	3,480	$30	$93.9K
99152	The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or…	2,080	$30	$64.6K
00630	The provider performs anesthesia services for a patient undergoing a procedure in lumbar region; not otherwise specified.	400	$130	$51.1K

Showing 1–10 of 60

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

Apex Medical Center — 8 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

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
64635	Under fluoroscopic or CT guidance, the provider applies an agent to a lower back joint to destroy nerve tissue.	15	20	150	$360	$234.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	12	150	1,440	$20	$193.7K
95913	In this procedure, the provider performs 13 or more nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	11	20	290	$170	$171.4K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	21	40	250	$140	$144.9K
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…	740	970	360	$80	$139.2K
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…	3	2,250	290	$60	$138K
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	9	30	120	$190	$108.7K
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…	48	2,480	330	$50	$107.6K
64494	In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that…	8	30	130	$140	$71.7K
64484	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection in the lumbar or sacral region. The code applies to each additional level…	12	20	160	$100	$66.9K

Showing 1–10 of 60

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dolue Ezeanolue	NV	Interventional Pain Medicine Physician	$623.5K	$164.3K
Alafuro Oruene	NV	Interventional Pain Medicine Physician	$127.4K	$111K

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
Iriye Medical Group PLLC	NV	Maternal & Fetal Medicine Physician	$0	$11.9M
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

Apex Medical Center — Billing Profile & Reimbursement Data

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Apex Medical Center — 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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