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.

Sean D. Palacios Md PLLC (NPI 1528340866)

Field	Value
Entity Type	Organization
Organization	Sean D. Palacios Md PLLC
Address	3692 E Sunset Rd
City	Las Vegas
State	NV
ZIP	89120
Taxonomy	Otology & Neurotology Physician
NPI Enumerated	September 13, 2011

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99203	The provider sees a new 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 provider…	6,380	$70	$420.9K
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…	7,650	$40	$336.7K
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…	1,540	$80	$118.7K
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…	930	$100	$89.6K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	3,130	$20	$59.5K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	5,920	$10	$47.3K
V5261	Hearing aid, digital, binaural, bte	80	$590	$46.9K
92593	N/A	1,370	$30	$36.9K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	110	$260	$27.1K
V5266	Battery for use in hearing device	2,350	$10	$21.2K

Showing 1–10 of 24

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

Sean D. Palacios Md PLLC — 4 of 23 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
V5261	Hearing aid, digital, binaural, bte	9	10	240	$590	$245.1K
V5110	Dispensing fee, bilateral	5	10	210	$410	$189.2K
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…	486	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…	165	2,480	330	$50	$107.6K
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…	79	780	90	$100	$46.6K
99203	The provider sees a new 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 provider…	10	860	100	$70	$42.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	3	10	90	$440	$42.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	2	10	50	$520	$34.5K
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…	48	90	70	$100	$32.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	10	30	890	$10	$29K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sean D. Palacios Md PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Terrance Kwiatkowski	NV	Otology & Neurotology Physician	$189.7K	$26.2K
Scott Manthei	NV	Otolaryngology/Facial Plastic Surgery Physician	$163.7K	$14.5K
Phillip Say	NV	Otolaryngology Physician	$55.7K	$79K
Joel Franco	NV	Otolaryngology Physician	$55.1K	$42.9K
Brian Kung	NV	Otology & Neurotology Physician	$89.2K	$0
Dawn Zaratiegui	NV	Nurse Practitioner	$41.2K	$22.7K
Carl Wilson	AZ	Physician Assistant	$44.3K	$9.7K

Nearby Providers

Other providers in the same ZIP code as Sean D. Palacios Md PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bio-medical Applications Of Nevada, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.4M
Caremax Health Group, LLC	NV	Durable Medical Equipment & Medical Supplies	$0	$6.2M
Renee Lim Ngo PC	NV	Psychiatry Physician	$0	$5.1M
Newway Neurotherapy Health And Wellness	NV	Psychiatry Physician	$0	$4.9M
Holy Infant Carin Pediatric Group, PLLC	NV	Pediatrics Physician	$0	$4.9M
Exellabs	NV	Clinical Medical Laboratory	$395.4K	$2.9M
Newway Neurotherapy Health And Wellness	NV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.3M
Docs On Go LLC	NV	Clinic/Center	$0	$3.1M
Edwin Suarez Physical Therapy, LLC	NV	Physical Therapist	$0	$3.1M
Motivated Kids Therapy LLC	NV	Pediatric Occupational Therapist	$0	$2.8M

Sean D. Palacios Md PLLC — Billing Profile & Reimbursement Data

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Sean D. Palacios Md PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References