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.

Silver Health Care PC (NPI 1548291586)

Silver Health Care PC is a internal medicine physician provider located in Silver City, New Mexico. This profile covers 0 Medicare and 114 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	Silver Health Care PC
Address	1600 E 32nd St
City	Silver City
State	NM
ZIP	88061
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 6, 2006

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

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

114 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	27,530	$90	$2.5M
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…	23,520	$60	$1.5M
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…	3,140	$100	$310.6K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	2,050	$140	$291K
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…	940	$160	$153.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	2,990	$30	$95.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,720	$20	$65.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	900	$70	$60.5K
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.	4,880	$10	$58.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,180	$20	$50K

Showing 1–10 of 114

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

Silver Health Care PC — 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

114 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	16	30	3,760	$120	$900.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	70	80	3,340	$60	$595K
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…	50	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…	31	960	1,010	$90	$490K
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…	84	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…	86	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,…	247	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.	44	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…	20	30	260	$50	$236.8K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	31	40	460	$90	$207.5K

Showing 1–10 of 114

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James Skee	NM	Internal Medicine Physician	$303.2K	$0
Colicia Meyerowitz	NM	Internal Medicine Physician	$195.7K	$0
Muskula Kumar	NM	Internal Medicine Physician	$153.4K	$0
Jennifer Sabatier	NM	General Practice Physician	$57.3K	$19.8K
Deandra Mahon	NM	Physician Assistant	$67.4K	$0
Julie Fitzgerald	CA	Medical Physician Assistant	$54.7K	$0
Kyle Green	NM	Physician Assistant	$52.8K	$0
John Mcmullen	AZ	Physician Assistant	$20.9K	$0
Linda Gosselin Chase	NM	Family Medicine Physician	$8.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gila Regional Medical Center	NM	Critical Access Hospital	$0	$33.3M
Trauma And Recovery Centers	NM	Mental Health Counselor	$0	$9.9M
Victor A. Nwachuku, M.d., PC	NM	Obstetrics Physician	$0	$2.6M
Supporting People In Need	NM	Social Worker	$0	$2.4M
Border Area Mental Health Services, Inc	NM	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.4M
Kids In Need Of Supportive Services	NM	Community/Behavioral Health Agency	$0	$2.1M
Recovery Management Center, PC	NM	Addiction (Substance Use Disorder) Counselor	$0	$2M
Hidalgo Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$1.9M
Home Medical Equipment Specialists, LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$1.7M
Nicholas Mittica	NM	Ophthalmology Physician	$273.7K	$0

Silver Health Care PC — Billing Profile & Reimbursement Data

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Silver Health Care PC — 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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