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.

Pioneer Health Care LLC (NPI 1588681332)

Pioneer Health Care LLC is a internal medicine physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 25 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	Pioneer Health Care LLC
Address	3540 W Sahara Ave
City	Las Vegas
State	NV
ZIP	89102
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicaid	$12.2M
Medicare	$0

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	72,680	$70	$5.2M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20,970	$150	$3.1M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	21,760	$80	$1.7M
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	16,720	$30	$551.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,240	$60	$461.4K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	5,030	$70	$331.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,300	$200	$259.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,090	$120	$240.7K
99220	N/A	830	$150	$120.7K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	3,020	$20	$66.5K

Showing 1–10 of 25

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

Pioneer Health Care LLC — 3 of 24 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	21	90	190	$160	$332.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6	470	380	$70	$281.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	65	430	500	$40	$214.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3	430	180	$130	$158K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	9	140	690	$40	$145.2K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	44	150	460	$20	$119.6K
99220	N/A	7	50	100	$130	$102.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2	230	160	$70	$99.1K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	4	60	190	$60	$97.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	23	210	110	$80	$68.6K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gina Balgoyen	NV	Family Nurse Practitioner	$1.1M	$0
Reza Mojtabavi	NV	Internal Medicine Physician	$313.7K	$52.7K
Wayne Seare	NV	Acute Care Nurse Practitioner	$307.9K	$0
Syed Rahman	NV	Geriatric Medicine (Internal Medicine) Physician	$288.4K	$14K
Zahid Hamid	NV	Specialist	$250K	$45K
Lady May Panelo	NV	Family Nurse Practitioner	$283.4K	$0
Cesar Noel Estillore	NV	Family Nurse Practitioner	$279.2K	$4K
Safdar Qureshi	NV	Internal Medicine Physician	$183.7K	$20.1K
Haitham Elconsul	NV	Hospitalist Physician	$199.2K	$0
Amir Shuja	NV	Internal Medicine Physician	$194.5K	$0

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
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
At Home Caregivers, LLC	NV	In Home Supportive Care Agency	$0	$7M

Pioneer Health Care LLC — Billing Profile & Reimbursement Data

Sign up for Pioneer Health Care LLC — Billing Profile & Reimbursement Data policy alerts

Pioneer Health Care LLC — Billing Profile & Reimbursement Data

Sign up for Pioneer Health Care LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References