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.

San Juan Medical Group PC (NPI 1609809235)

Field	Value
Entity Type	Organization
Organization	San Juan Medical Group PC
Address	622 W Maple St
City	Farmington
State	NM
ZIP	87401
Taxonomy	Family Medicine Physician
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

58 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…	18,170	$90	$1.7M
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…	23,150	$70	$1.5M
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.	4,870	$40	$204.6K
0241U	N/A	1,300	$140	$183.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	940	$110	$100K
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…	970	$80	$76.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	560	$110	$60.7K
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…	980	$50	$48.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	7,120	$10	$35.6K
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…	210	$110	$21.9K

Showing 1–10 of 58

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

San Juan Medical Group 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

58 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…	51	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…	48	960	1,010	$90	$490K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	20	20	50	$110	$463.7K
0241U	N/A	14	30	1,080	$150	$353.2K
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…	75	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,…	288	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.	55	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…	10	30	260	$50	$236.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	42	120	430	$110	$205.4K
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…	71	130	1,500	$10	$149.6K

Showing 1–10 of 58

Related Providers

Other providers that share a Tax Identification Number (TIN) with San Juan Medical Group PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Hakes	NM	Family Medicine Physician	$372.4K	$0
Taylor Wade	NM	Family Medicine Physician	$286.6K	$0
Lance Harmon	NM	Family Medicine Physician	$280.5K	$0
Mark Himes	NM	Sports Medicine (Family Medicine) Physician	$249.7K	$0

Nearby Providers

Other providers in the same ZIP code as San Juan Medical Group PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Juan Regional Medical Center, Inc.	NM	General Acute Care Hospital	$0	$141.5M
Basin Coordinated Healthcare,inc	NM	Personal Care Attendant	$0	$79.7M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$41.2M
Links Ii Inc	NM	In Home Supportive Care Agency	$0	$38.9M
Generations Personal Care, Inc	NM	Personal Care Attendant	$0	$33.9M
Southwestern Private Services, Inc.	NM	Home Health Agency	$0	$30.4M
San Juan Regional Medical Center Inc	NM	Emergency Medicine Physician	$0	$23.8M
San Juan Center For Independence	NM	Home Health Agency	$0	$22.5M
Cottonwood Clinical Services, Inc.	NM	Community/Behavioral Health Agency	$0	$18.1M
San Juan Regional Medical Center Inc	NM	Pediatrics Physician	$0	$15.7M

San Juan Medical Group PC — Billing Profile & Reimbursement Data

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San Juan Medical Group 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

Related Providers

Nearby Providers

Frequently Asked Questions

References