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.

Bca Medical Associates, PA (NPI 1568576056)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bca Medical Associates, PA
Address	813 N Washington Ave
City	Roswell
State	NM
ZIP	88201
Taxonomy	Pediatrics Physician
NPI Enumerated	August 19, 2006

Payer Source	Total Paid
Medicaid	$41.2M
Medicare	$0

BCA MEDICAL ASSOCIATES, PA is effectively a single-payer Medicaid practice for the period on file: there is no Medicare revenue on record and total Medicaid revenue is $41.2M, indicating this entity operates primarily within the pediatric Medicaid market rather than serving a Medicare population. The provider’s NPI has been enumerated since 2006-08-19 (~20 years), supporting a long-tenured presence in the market.

Revenue is highly concentrated in a few office and preventive pediatric visit codes: the top 3 Medicaid codes by revenue account for 46.8% of total Medicaid revenue, and the two highest-volume E/M codes, 99213 ($9.3M, 23.0%) and 99214 ($6.6M, 16.5%), together represent a large share of billed services, reflecting a practice focused on routine and established patient outpatient care. This concentration implies operational emphasis on high-volume clinic visits rather than specialized procedural revenue streams.

The code mix and volumes point to a comprehensive pediatric primary care and preventive services operation: high-ranking preventive medicine codes 99392, 99393, 99391, and 99394 (combined multi-million dollar revenues) and substantial vaccine administration codes 90460, 90461, 90756, 90672 indicate routine well-child visits, immunization programs, and age-based preventive workflows are central to the business model. These patterns are consistent with a clinic managing large pediatric panels and scheduled well visits.

BCA is a statewide volume leader for multiple pediatric screening and preventive procedures: several codes rank at the 99th–100th percentile in-state (e.g., 99392 rank #2 of 122; 99393 rank #2 of 124; 92587 rank #1 of 27; 99177 rank #1 of 20; 96110 rank #1 of 62), and many entries are labeled “extreme outlier” or “100th percentile,” indicating the provider is a dominant in-state performer for hearing/vision screenings, developmental screening, and well-child visits. This competitive standing suggests scale advantages in delivering pediatric preventive services across the payer’s Medicaid population.

High claim volumes for diagnostic screening and point-of-care testing codes further characterize daily clinical operations: large counts for U0002 (35.2K claims, $1.9M), 87804 (59.2K claims, $1.0M), and 87880 (19.9K claims, $337.8K) show the practice performs frequent respiratory and infectious disease testing, while vision/hearing screenings (99177, 92587) and developmental screening (96110) are consistently billed at very high state ranks — reinforcing a model of bundled well-child encounters with integrated screening and testing.

Several preventive counseling and care-complexity add-on codes are also highly represented: G0447 (39.4K claims, $1.1M) for obesity counseling and G2211 (8.4K claims, $133.9K) for increased visit complexity both rank at or near the top in-state, indicating the clinic provides structured counseling and manages patients with care needs that justify complexity add-on billing. This suggests protocols for anticipatory guidance and management of chronic or complex pediatric issues are embedded in visit workflows.

Operational throughput is evident in very large claim counts for vaccine administration and related visit codes (90460: 69.6K claims; 90461: 34.4K claims) and in the prevalence of well-visit codes across age bands (99391–99394), which aligns with a high-volume throughput model likely driven by scheduled immunization and well-child visit delivery. These volumes, coupled with top-state rankings for vaccine and well-visit codes, point to capacity for mass pediatric preventive services in its local market.

While many codes are extreme in-state outliers, some common office codes show more typical statewide positioning: 99212 (8.8K claims) ranks at the 97th percentile and 80061 (11.7K claims) at the 91st percentile, indicating that although the provider dominates preventive and screening services, its diagnostic lab and lower-complexity E/M activity are high but not universally exceptional relative to all in-state peers. This nuance suggests the clinic’s standout differentiation is concentrated in pediatric preventive/screening workflows rather than every service line.

Medicaid: Complete Services Breakdown

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

112 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	130,380	$70	$9.3M
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…	60,320	$110	$6.6M
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…	27,650	$110	$2.9M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	27,310	$100	$2.8M
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…	23,600	$110	$2.5M
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	35,220	$50	$1.9M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	17,660	$100	$1.8M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	69,620	$20	$1.6M
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	34,420	$40	$1.5M
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	70,480	$20	$1.5M

Showing 1–10 of 112

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

Bca Medical Associates, PA — 24 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

112 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.	103	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…	7	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…	15	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…	4	100	1,100	$110	$362K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	22	20	250	$410	$330.3K
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…	2	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,…	13	380	220	$160	$273.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2	120	430	$110	$205.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	79	90	1,570	$30	$183.1K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	122	130	1,500	$10	$149.6K

Showing 1–10 of 112

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aspire Developmental Services, LLC	NM	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$45.5M
Roswell Hospital Corporation	NM	General Acute Care Hospital	$0	$41.3M
Lovelace Health System LLC	NM	General Acute Care Hospital	$0	$20.1M
Pathology Consultants Of New Mexico	NM	Anatomic Pathology Physician	$376.7K	$18M
Roswell Clinic Corp	NM	Family Medicine Physician	$0	$14.7M
La Casa De Buena Salud Inc	NM	Federally Qualified Health Center (FQHC)	$0	$11M
Masoud Khorsand- Sahbaie Md P A	NM	Hematology & Oncology Physician	$0	$8.1M
Agape Home Care LLC	NM	Supports Brokerage Agency	$0	$7.4M
Roswell Family Care, LLC	NM	Family Nurse Practitioner	$0	$6.3M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$6M

Bca Medical Associates, PA — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References