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.

Nelson Lopez (NPI 1528299377)

Nelson Lopez is a ophthalmology physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 14 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	Individual
Organization	Nelson Lopez
Address	3100 W Charleston Blvd Ste 204
City	Las Vegas
State	NV
ZIP	89102
Taxonomy	Ophthalmology Physician
NPI Enumerated	July 28, 2009

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,270	$160	$852.9K
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…	6,210	$90	$577.1K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	4,670	$100	$447.9K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	5,600	$50	$296.9K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	6,400	$40	$236.7K
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…	2,580	$60	$162.7K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	10,120	$20	$161.9K
92285	Code 92285 describes photography of abnormalities using any of the methods described for documentation purposes and later comparison.	5,690	$20	$91.1K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	150	$110	$16.7K
92025	The provider measures the curvature of one or both corneas, interprets the findings, and prepares a report.	300	$30	$9.7K

Showing 1–10 of 14

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

Nelson Lopez — 4 of 13 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	171	2,250	290	$60	$138K
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…	376	2,480	330	$50	$107.6K
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…	2	80	80	$150	$91.2K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	3	30	60	$60	$64K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	14	330	240	$60	$55.1K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	5	40	210	$20	$47.3K
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…	413	780	90	$100	$46.6K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	25	90	70	$100	$32.9K
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.	241	310	260	$10	$27.2K
92025	The provider measures the curvature of one or both corneas, interprets the findings, and prepares a report.	4	10	270	$20	$25.3K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Irene Voo	NV	Ophthalmology Physician	$2.7M	$0
Green Valley Surgery Center LLC	NV	Ambulatory Surgical Clinic/Center	$2.3M	$363.3K
Stonecreek Surgery Center LLC	NV	Ambulatory Surgical Clinic/Center	$977K	$622.9K
Cheryl Lee	WA	Ophthalmology Physician	$1.5M	$0
Shepherd Eye Center, Ltd	NV	Ophthalmology Physician	$0	$1.4M
Julie Park-chang	NV	Optometrist	$8.4K	$1.3M
Las Vegas East Ophthalmology Asc LLC	NV	Ambulatory Surgical Clinic/Center	$1.2M	$94K
Jason Wickens	NV	Ophthalmology Physician	$1.2M	$9.1K
Charles Calvo	NV	Retina Specialist (Ophthalmology) Physician	$1M	$0
Meher Yepremyan	NV	Ophthalmology Physician	$982.3K	$1.8K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Medical Center Of Southern Nevada	NV	General Acute Care Hospital	$0	$95.5M
Unlv Medicine	NV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$31.4M
Unlv Medicine	NV	Internal Medicine Physician	$0	$22M
Pioneer Health Care LLC	NV	Internal Medicine Physician	$0	$12.2M
New Hope Placement, LLC	NV	Community/Behavioral Health Agency	$0	$11.1M
Coppel Medical Enterprise LLC	NV	Pain Medicine (Anesthesiology) Physician	$0	$10.4M
Coppel Surgical Solutions	NV	Ambulatory Surgical Clinic/Center	$664.2K	$8.1M
Golden Years Personal Care LLC	NV	In Home Supportive Care Agency	$0	$8M
A-team Personal Care, LLC	NV	In Home Supportive Care Agency	$0	$7.9M
West Las Vegas Surgery Center,llc	NV	Ambulatory Surgical Clinic/Center	$1.2M	$6M

Nelson Lopez — Billing Profile & Reimbursement Data

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Nelson Lopez — 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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