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.

San Juan Regional Medical Center Inc (NPI 1528141843)

San Juan Regional Medical Center Inc is a neurology physician provider located in Farmington, New Mexico. This profile covers 0 Medicare and 19 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	San Juan Regional Medical Center Inc
Address	2300 E 30th St
City	Farmington
State	NM
ZIP	87401
Taxonomy	Neurology Physician
NPI Enumerated	October 23, 2006

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0585	Injection, onabotulinumtoxina, 1 unit	3,630	$470	$1.7M
64615	The provider bilaterally administers a chemical compound to the muscles innervated by the trigeminal, facial, cervical spinal, and accessory nerves. The goal of this procedure is to paralyze the…	1,670	$130	$209.1K
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…	2,630	$70	$181.5K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	1,530	$100	$147.1K
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…	1,350	$90	$121.4K
95909	In this procedure, the provider performs five or six nerve conduction studies, a diagnostic test to evaluate the function, especially the ability of electrical conduction of the motor and sensory…	450	$120	$52.1K
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…	230	$140	$31.6K
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…	560	$50	$30.4K
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…	80	$130	$9.9K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	50	$190	$9.4K

Showing 1–10 of 19

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

San Juan Regional Medical Center Inc — 1 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	74	80	10,650	$130	$2.4M
J0585	Injection, onabotulinumtoxina, 1 unit	4	20	810	$520	$1.6M
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…	544	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…	290	960	1,010	$90	$490K
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,…	332	380	220	$160	$273.9K
64615	The provider bilaterally administers a chemical compound to the muscles innervated by the trigeminal, facial, cervical spinal, and accessory nerves. The goal of this procedure is to paralyze the…	4	10	400	$120	$180.9K
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…	54	320	220	$110	$146.2K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	31	30	100	$160	$133.4K
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…	233	380	150	$130	$132.8K
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…	42	150	90	$170	$48.4K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Juan Regional Medical Center, Inc.	NM	General Acute Care Hospital	$0	$141.5M
San Juan Regional Medical Center Inc	NM	Emergency Medicine Physician	$0	$23.8M
San Juan Regional Medical Center Inc	NM	Pediatrics Physician	$0	$15.7M
San Juan Regional Medical Center Inc	NM	Family Medicine Physician	$0	$7.9M
Orthopedic Associates PA	NM	Orthopaedic Surgery Physician	$0	$4.4M
San Juan Regional Medical Center Inc	NM	Hospitalist Physician	$0	$3.6M
San Juan Regional Medical Center Inc	NM	Internal Medicine Physician	$0	$1.5M
Clayton Labaume	CO	Surgical Physician Assistant	$1.4M	$0
San Juan Regional Medical Center Inc	NM	Psychiatry Physician	$0	$1.4M
Graeme Fisher	IL	Therapeutic Radiology Physician	$658K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Basin Coordinated Healthcare,inc	NM	Personal Care Attendant	$0	$79.7M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$41.2M
Links Ii Inc	NM	In Home Supportive Care Agency	$0	$38.9M
Generations Personal Care, Inc	NM	Personal Care Attendant	$0	$33.9M
Southwestern Private Services, Inc.	NM	Home Health Agency	$0	$30.4M
San Juan Center For Independence	NM	Home Health Agency	$0	$22.5M
Cottonwood Clinical Services, Inc.	NM	Community/Behavioral Health Agency	$0	$18.1M
Better Together Home And Community Services, LLC	NM	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$14.5M
Southwestern Private Services, Inc	NM	Home Health Agency	$0	$7.3M
Pms Dba Roundtree Childrens' Development Services	NM	Developmental Disabilities Clinic/Center	$0	$6.9M

San Juan Regional Medical Center Inc — 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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