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.

Virgil Hernandez (NPI 1659395598)

Field	Value
Entity Type	Individual
Organization	Virgil Hernandez
Address	801 N Tustin Ave
City	Santa Ana
State	CA
ZIP	92705
Taxonomy	Foot & Ankle Surgery Podiatrist
NPI Enumerated	July 26, 2006

Payer Source	Total Paid
Medicare	$1.7M
Medicaid	$0

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
11045	The provider uses surgical instruments to remove dead tissue from the subcutaneous layer, as well as the epidermis and dermis if needed. She performs this service at the same session as a separately…	20,830	$40	$729.2K
97598	After debriding the initial 20 cm2 at the same encounter, the provider excises devitalized (dead) tissue from an open wound. He may use a variety of techniques that include sharp debridement with…	13,840	$40	$553.6K
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.	1,880	$120	$218.5K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	1,840	$90	$167.4K
99342	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a low level of medical decision making or the provider spends at least 30…	10	$70	$720

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. California Distribution

Virgil Hernandez — 4 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97598	1	30	120	$30	$27.3K
11042	7	1,030	100	$80	$18.1K
11045	1	210	170	$30	$10.9K
97597	3	440	60	$70	$8.6K
99342	284	290	40	$60	$4.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tustin Aba Services For Kids LLC	CA	Behavior Analyst	$0	$23.2M
Equaltox, LLC	CA	Clinical Medical Laboratory	$1.5M	$7.3M
Newport Labs Inc	CA	Clinical Medical Laboratory	$413.1K	$4.6M
Rajiv Rathod	CA	Ophthalmology Physician	$4.3M	$670.6K
Timothy You	CA	Ophthalmology Physician	$4.5M	$115.9K
Esther Kim	CA	Retina Specialist (Ophthalmology) Physician	$4.2M	$15.7K
First Rate Lab LLC	CA	Clinical Medical Laboratory	$3M	$951.1K
Sanford Chen	CA	Ophthalmology Physician	$2.8M	$190
Desmond Mcguire	CA	Retina Specialist (Ophthalmology) Physician	$1.4M	$1.1M
Illuminate Diagnostics Inc	CA	Clinical Medical Laboratory	$1.5M	$940.8K

Virgil Hernandez — Billing Profile & Reimbursement Data

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Virgil Hernandez — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References