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.

New Mexico Primary Care Group P.C. (NPI 1528201597)

New Mexico Primary Care Group P.C. is a internal medicine physician provider located in Las Cruces, New Mexico. This profile covers 0 Medicare and 94 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	New Mexico Primary Care Group P.C.
Address	179 Howard Pl
City	Las Cruces
State	NM
ZIP	88011
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 7, 2009

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

94 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,710	$360	$617.2K
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…	5,540	$90	$509.8K
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…	8,490	$60	$492.3K
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…	1,860	$120	$225.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,580	$100	$162.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,100	$100	$112.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,290	$50	$105.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	4,880	$20	$102.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	840	$100	$82.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	260	$290	$73.2K

Showing 1–10 of 94

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

New Mexico Primary Care Group P.C. — 1 of 25 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

94 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	60	140	130	$220	$568.5K
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…	135	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…	170	960	1,010	$90	$490K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	11	30	100	$770	$447.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	8	30	340	$250	$395.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	52	100	1,100	$110	$362K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	43	120	670	$110	$301.2K
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,…	81	380	220	$160	$273.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	51	100	2,650	$10	$265.6K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	12	30	260	$50	$236.8K

Showing 1–10 of 94

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sangeeth Pai	NM	Internal Medicine Physician	$389.9K	$0
Vanessa Santana	TN	Family Nurse Practitioner	$66.1K	$0
Hedsna Rocha	NM	Family Nurse Practitioner	$64.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Shadows Home Care Services, Inc	NM	Home Health Agency	$0	$92.9M
Las Cruces Medical Center LLC	NM	General Acute Care Hospital	$0	$86.8M
Addus Healthcare, Inc.	NM	In Home Supportive Care Agency	$0	$81.1M
Phc-las Cruces Inc	NM	General Acute Care Hospital	$0	$64.8M
Las Cruces Physician Services LLC	NM	Orthopaedic Surgery Physician	$0	$62.9M
Multicultural Evaluation & Consultation Associates LLC	NM	Early Intervention Provider Agency	$0	$59.3M
Quality Life Services, LLC	NM	Specialist	$0	$44.9M
Las Cruces Physician Practices, LLC	NM	Family Medicine Physician	$0	$22.8M
Southwest Emergency Medical Associates Of Nm PC	NM	Emergency Medicine Physician	$0	$20.3M
Milagro De Vida Community Services LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.2M

New Mexico Primary Care Group P.C. — Billing Profile & Reimbursement Data

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New Mexico Primary Care Group P.C. — 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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