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 California for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to California 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. California (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.

Pankaj K. Patel, Dmd & Shailesh K. Patel, Dds A Prof Corp (NPI 1588875967)

Field	Value
Entity Type	Organization
Organization	Pankaj K. Patel, Dmd & Shailesh K. Patel, Dds A Prof Corp
Address	5712 Pirrone Rd
City	Salida
State	CA
ZIP	95368
Taxonomy	Ambulatory Surgical Clinic/Center
NPI Enumerated	May 25, 2007

Payer Source	Total Paid
Medicaid	$33M
Medicare	$0

Medicaid: Complete Services Breakdown

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

57 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2930	N/A	56,450	$120	$6.6M
D9223	N/A	11,000	$400	$4.4M
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	9,520	$380	$3.6M
D3220	N/A	32,850	$100	$3.2M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	34,960	$60	$2M
D9420	N/A	17,590	$90	$1.7M
D9610	N/A	16,430	$80	$1.4M
D9222	N/A	10,800	$120	$1.3M
D9221	N/A	5,360	$240	$1.3M
D9220	N/A	5,300	$210	$1.1M

Showing 1–10 of 57

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other California providers billing the same CPT/HCPCS codes.

Claims Volume vs. California Distribution

Pankaj K. Patel, Dmd & Shailesh K. Patel, Dds A Prof Corp — 17 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

57 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	184	200	550	$310	$605.9K
0160	N/A	32	150	560	$340	$557.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	11	50	320	$220	$542.5K
D2930	N/A	4	720	880	$120	$436.7K
D9223	N/A	8	280	360	$250	$435.2K
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	323	410	1,130	$70	$372K
0360	N/A	57	260	960	$120	$350.3K
0490	N/A	41	80	520	$150	$323.2K
D9420	N/A	2	70	650	$80	$290.1K
D3220	N/A	4	650	660	$100	$259.2K

Showing 1–10 of 57

Pankaj K. Patel, Dmd & Shailesh K. Patel, Dds A Prof Corp — Billing Profile & Reimbursement Data

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Pankaj K. Patel, Dmd & Shailesh K. Patel, Dds A Prof Corp — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References