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.

Direct Healthcare (NPI 1619052107)

Field	Value
Entity Type	Organization
Organization	Direct Healthcare
Address	5309 Sultan St
City	Las Vegas
State	NM
ZIP	87701
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$15.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	26,890	$300	$8M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	103,750	$60	$6.1M
G9006	Coordinated care fee, home monitoring	4,960	$220	$1.1M
S9999	Sales tax	1,190	$20	$21.5K

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

Direct Healthcare — 0 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	36	80	20,990	$310	$16.4M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	39	90	92,900	$70	$13.3M
G9006	Coordinated care fee, home monitoring	36	80	3,840	$190	$2M
S9999	Sales tax	62	160	800	$10	$25.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Care, LLC.	NM	In Home Supportive Care Agency	$0	$52.8M
Victory Personal Care Inc.	NM	Home Health Agency	$0	$26.9M
Heritage Healthcare Of Northern New Mexico, Inc.	NM	Home Health Agency	$0	$14.8M
An Angels Touch LLC	NM	In Home Supportive Care Agency	$0	$13.4M
San Miguel Hospital Corporation	NM	General Acute Care Hospital	$0	$13.2M
El Centro Family Health	NM	Federally Qualified Health Center (FQHC)	$0	$7.3M
Rainbow Road Therapies, Inc.	NM	Developmentally Disabled Services Day Training Agency	$0	$6.5M
State Of New Mexico	NM	Nursing Facility/Intermediate Care Facility	$0	$4.2M
Summit Emergency Medicine LLC	NM	Emergency Medicine Physician	$0	$3.1M
San Miguel Hospital Corporation	NM	Critical Access Hospital	$0	$3M

Direct Healthcare — Billing Profile & Reimbursement Data

Sign up for Direct Healthcare — Billing Profile & Reimbursement Data policy alerts

Direct Healthcare — Billing Profile & Reimbursement Data

Sign up for Direct Healthcare — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References