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    v1.0.28
    OpenPayerNPI Medicare & MedicaidEdmundo Rubio
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    Edmundo Rubio — Billing Profile & Reimbursement Data

    NPI 1619073491 · Roanoke, VA · Pulmonary Disease Physician

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    Edmundo Rubio is a pulmonary disease physician provider located in Roanoke, Virginia. This profile covers 17 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationEdmundo Rubio
    Address2001 Crystal Spring Ave Sw
    CityRoanoke
    StateVA
    ZIP24014
    TaxonomyPulmonary Disease Physician
    NPI EnumeratedSeptember 16, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$88.2K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    17 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99291Critical 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…200$170$33.3K
    95811During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.160$90$14.2K
    95810Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…120$90$10.3K
    99233The 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…110$90$9.8K
    99214The 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…70$70$4.9K
    99232The 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…60$60$3.7K
    99215The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…30$100$2.9K
    99204The provider sees a new 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 provider…30$90$2.5K
    99222The 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…20$100$1.8K
    99223The 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…10$140$1.5K

    Showing 1–10 of 17

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    17 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992148,60112,890140$80$21K
    958101312050$290$16.2K
    95811511040$300$15.7K
    992331,3393,29080$90$13.7K
    992911161,95050$170$12.2K
    992322,5854,46080$60$11K
    9921312,06812,44090$60$10K
    992152,4564,03040$120$9.5K
    992233,5583,66040$130$9.2K
    992044,0976,85040$110$5.9K

    Showing 1–10 of 17

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Edmundo Rubio, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Carilion Medical CenterVAGeneral Acute Care Hospital$0$124.7M
    Carilion Medical CenterVAMulti-Specialty Clinic/Center$0$73.4M
    Carilion Healthcare CorporationVAMulti-Specialty Clinic/Center$0$26.1M
    Carilion Franklin Memorial HospitalVAGeneral Acute Care Hospital$0$18.4M
    Carilion Medical CenterVAEmergency Medicine Physician$0$18.1M
    Stonewall Jackson Memorial Hospital CompanyWVRural Acute Care Hospital$0$13M
    Carilion Rockbridge Community HospitalVACritical Access Hospital$0$11.8M
    Shaya AnsariNYDiagnostic Radiology Physician$1.5M$1K
    Mrunal TailorNMDiagnostic Radiology Physician$897.5K$0
    Llewellyn LeeTXVascular & Interventional Radiology Physician$834.2K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Carilion Emergency Services, Inc.VAUrgent Care Clinic/Center$0$11.1M
    Carilion Clinic Patient Transportation, LLCVAAir Ambulance$2.6M$6.1M
    Quest Diagnostics Clinical Laboratories IncVAClinical Medical Laboratory$3.9M$186.2K
    Mark KochenderferVAHematology & Oncology Physician$2.5M$0
    Amanda Gillespie-twardyVAHematology & Oncology Physician$1.9M$0
    Suzan MertenVAHematology & Oncology Physician$1.8M$90
    Padmaja MallidiVAHematology & Oncology Physician$1.7M$0
    Fairlawn Surgery Center, LLCVAAmbulatory Surgical Clinic/Center$997K$572.4K
    Donald VileVAHematology & Oncology Physician$1.4M$0
    Joshua MoralesVAHematology & Oncology Physician$886.1K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Virginia Distribution
    Edmundo Rubio — 1 of 17 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Virginia