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

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

Jeffrey Albores (NPI 1497917405)

Jeffrey Albores is a pulmonary disease physician provider located in Tacoma, Washington. This profile covers 18 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Jeffrey Albores
Address	1708 Yakima Ave Ste 300
City	Tacoma
State	WA
ZIP	98405
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	June 30, 2008

Payer Source	Total Paid
Medicare	$123K
Medicaid	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	280	$160	$44.7K
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…	400	$90	$35.7K
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…	220	$90	$19.9K
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…	130	$60	$7.7K
99204	The provider sees a new 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 provider…	20	$110	$2.4K
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…	20	$130	$2.2K
36556	The provider inserts a central venous access catheter in the neck, chest, or groin to draw blood or administer medication or nutrients to a patient 5 years of age or older.	30	$60	$1.6K
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…	30	$60	$1.5K
31645	The provider uses a rigid or flexible bronchoscope to view the airways and aspirates (sucks out) fluid from the tracheobronchial tree, the branched distribution of airways of the lung that includes…	20	$90	$1.3K
99292	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…	20	$80	$1.2K

Showing 1–10 of 18

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	990	10,860	100	$80	$13.6K
99233	354	2,420	60	$90	$10.4K
99291	11	1,430	40	$170	$9.1K
99232	2,514	3,100	70	$60	$7.5K
99213	2,519	9,690	60	$60	$6.5K
99223	1,935	2,570	30	$130	$6.4K
99204	3,038	4,750	30	$110	$5.2K
36415	1,668	1,920	60	$10	$3.5K
99292	91	100	30	$90	$3.4K
94729	27	190	60	$30	$2.3K

Jeffrey Albores — Billing Profile & Reimbursement Data

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Jeffrey Albores — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References