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.

Southern California Emergency Medicine (NPI 1639314255)

Southern California Emergency Medicine is a urgent care clinic/center provider located in San Bernardino, California. This profile covers 0 Medicare and 136 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	Southern California Emergency Medicine
Address	2101 N Waterman Ave
City	San Bernardino
State	CA
ZIP	92404
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	December 10, 2008

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

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

136 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…	338,810	$40	$12.9M
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…	336,200	$20	$8.1M
99203	The provider sees a new 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 provider…	111,290	$60	$6.3M
99204	The 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…	67,680	$70	$4.7M
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	35,410	$10	$212.4K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	2,820	$60	$177.3K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	1,570	$70	$115.8K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	86,880	$1	$86.9K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	10,130	$10	$70.9K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	58,850	$1	$58.8K

Showing 1–10 of 136

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

Southern California Emergency Medicine — 11 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

136 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	63	140	2,390	$70	$590.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	756	780	1,160	$130	$576.2K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	520	690	890	$80	$240.7K
E0114	Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips	13	60	170	$30	$203.3K
L3924	Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf	4	10	1,680	$40	$174.5K
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…	3	13,300	640	$40	$169.6K
J3490	Unclassified drugs	446	1,390	670	$20	$159.5K
99215	The 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…	1,103	4,230	210	$110	$135K
L3908	Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf	24	110	130	$30	$123.7K
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…	30	14,520	760	$10	$122.8K

Showing 1–10 of 136

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dignity Health	CA	General Acute Care Hospital	$0	$133.1M
Inpatient Specialists Of California, PC	CA	Internal Medicine Physician	$0	$32.9M
Abria Del Cielo	CA	Assisted Living Facility	$0	$23.3M
John Evans	CA	Gastroenterology Physician	$337.3K	$720.5K
Linda Enriquez	CA	Anatomic Pathology & Clinical Pathology Physician	$886K	$0
Sun Kim	CA	Urology Physician	$434.6K	$7.5K
Rajiv Malik	CA	Hematology & Oncology Physician	$359.2K	$0
Yaser Slayyeh	CA	Specialist	$256.3K	$20.8K
Maira Simental	CA	Radiation Oncology Physician	$132.4K	$0
Talal Samaan	CA	Internal Medicine Physician	$73.5K	$0

Southern California Emergency Medicine — Billing Profile & Reimbursement Data

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Southern California Emergency Medicine — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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