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 Armed Forces Pacific for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Armed Forces Pacific 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. Armed Forces Pacific (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.

Tequilla Pryor (NPI 1568807741)

Field	Value
Entity Type	Individual
Organization	Tequilla Pryor
Address	Psc 482 Box 1600
City	Fpo
State	AP (Armed Forces Pacific)
ZIP	96362
Taxonomy	Pediatrics Physician
NPI Enumerated	May 1, 2013

Payer Source	Total Paid
Medicaid	$3.3K
Medicare	$0

Key Findings

This provider has no Medicare billing on file and $3.3K in lifetime Medicaid revenue, so the recorded federal program billing footprint is effectively single‑payer and entirely within Medicaid. The absence of Medicare activity prevents direct cross‑payer revenue comparisons for this NPI.

Medicaid revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider’s Medicaid revenue, and a single code, 99213, is shown as accounting for $3.3K (100.0%) of Medicaid revenue. This concentration means the provider’s Medicaid performance is driven entirely by one outpatient E/M service line in the available data.

Code 99213 is described as an established patient office or other outpatient visit with low medical decision making and/or 20 or more minutes of total time; the presence of 99213 as the sole revenue generator indicates an ambulatory pediatric practice focused on routine, low‑complexity follow‑up and problem‑management visits rather than procedural or high‑acuity services. The Medicaid file shows 75 claims at $44 avg paid/claim, consistent with routine office visit billing.

Competitive standing for the primary Medicaid code is modest: 99213 ranks #3 of 4 providers in‑state (33th percentile; typical, unremarkable volume for this code), so this provider is not a dominant statewide player for that service and currently performs at about the middle/lower range of in‑state peers. The rank and percentile suggest routine participation rather than market leadership.

The NPI was enumerated 2013-05-01 (~13 years ago), indicating a long‑standing enrollment. Despite that tenure, the small Medicaid revenue total ($3.3K) suggests a limited billed patient panel under this NPI during the period in the dataset, which may reflect part‑time clinical activity, a small practice scale, or that care is billed under other affiliated NPIs or payer channels not shown here.

From an operational and reimbursement perspective, 75 Medicaid claims at $44 avg paid/claim producing $3.3K in total revenue highlights low per‑claim reimbursement and limited aggregate Medicaid income; this constrains revenue scale from fee‑for‑service Medicaid and suggests limited financial contribution from the billed outpatient E/M line. Analysts should view Medicaid financial exposure as small but highly dependent on continued billing of 99213.

Data limitations: the absence of Medicare billing and the extremely narrow code mix in Medicaid limit broader inferences about clinical scope or market position. Percentile and ranking comparisons are based on small counts and should be corroborated with commercial claims, group/organizational affiliations, or other NPIs to determine whether this NPI represents a small independent practice, a part‑time provider, or activity billed elsewhere.

Medicaid: Complete Services Breakdown

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

1 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…	80	$40	$3.3K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Armed Forces Pacific providers billing the same CPT/HCPCS codes. Note: "AP" is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; claims coded under it are benchmarked here as their own state-equivalent group.

Claims Volume vs. Armed Forces Pacific Distribution

Tequilla Pryor — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Armed Forces Pacific

Full comparison — all codes billed, vs. Armed Forces Pacific median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	3	10	370	$50	$18.2K

Nearby Providers

Other providers in the same ZIP code as Tequilla Pryor, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Santiago	AP (Armed Forces Pacific)	Internal Medicine Physician	$154K	$0
Cameron Colvig	AP (Armed Forces Pacific)	Emergency Medicine Physician	$0	$47.7K
Lydia Hunter	AP (Armed Forces Pacific)	Physical Therapist	$29.5K	$0
Roger Davis	AP (Armed Forces Pacific)	Certified Registered Nurse Anesthetist	$20.3K	$0
Jeffrey Pearson	—	Physician Assistant	$12.5K	$0
Zach Tarrillion	AP (Armed Forces Pacific)	Military Health Care Provider	$5.6K	$0
Victor Gutierrez	AP (Armed Forces Pacific)	Emergency Medicine Physician	$5.4K	$0
Kristin Armstrong	AP (Armed Forces Pacific)	Hand Occupational Therapist	$2.1K	$0

Tequilla Pryor — Billing Profile & Reimbursement Data

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Tequilla Pryor — 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