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.

Breatheamerica Albuquerque, Inc. (NPI 1659607414)

Breatheamerica Albuquerque, Inc. is a allergy physician provider located in Albuquerque, New Mexico. This profile covers 0 Medicare and 31 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	Breatheamerica Albuquerque, Inc.
Address	4901 Lang Ave Ne
City	Albuquerque
State	NM
ZIP	87109
Taxonomy	Allergy Physician
NPI Enumerated	October 28, 2009

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	5,190	$250	$1.3M
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…	6,450	$90	$586.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	3,480	$140	$501.7K
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…	2,840	$150	$420.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	42,540	$10	$382.9K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	3,750	$40	$161.4K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	790	$160	$127.7K
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…	1,910	$60	$108.8K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	3,520	$30	$95K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	530	$170	$88.5K

Showing 1–10 of 31

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

Breatheamerica Albuquerque, Inc. — 3 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2357	Injection, omalizumab, 5 mg	3	10	1,200	$1,770	$1.4M
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…	339	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…	147	960	1,010	$90	$490K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2	30	100	$770	$447.8K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	3	30	340	$250	$395.7K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	14	10	100	$220	$153.8K
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…	160	320	220	$110	$146.2K
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…	203	360	220	$90	$134.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	7	30	100	$160	$133.4K
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…	23	380	150	$130	$132.8K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christopher Thompson	TX	Otolaryngology Physician	$588.5K	$0
Richard Wachs	NM	Allergy Physician	$487.4K	$0
Stacy Silvers	TX	Allergy & Immunology Physician	$313.1K	$0
Lily Love	NM	Otolaryngology Physician	$101.2K	$0
Roland Gerencer	FL	Otolaryngology Physician	$92.3K	$0
Teresa Jenkins-mccord	NM	Allergy & Immunology Physician	$19.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presbyterian Healthcare Services	NM	Internal Medicine Physician	$0	$240.8M
Heritage Home Healthcare Services, Inc.	NM	Home Health Agency	$0	$141.5M
Home Medical Equipment Specialists LLC	NM	Durable Medical Equipment & Medical Supplies	$0	$100M
The New Beginnings LLC	NM	Adult Day Care Clinic/Center	$0	$85.1M
We Care Agency, Inc.	NM	In Home Supportive Care Agency	$0	$60.1M
Lovelace Health System, LLC	NM	General Acute Care Hospital	$0	$57.7M
Adelante Development Center, Inc.	NM	Personal Care Attendant	$0	$57M
Eye Associates Of New Mexico Ltd	NM	Ophthalmology Physician	$0	$46.9M
Southwest Labs LLC	NM	Clinical Medical Laboratory	$1.1M	$41.5M
Southwest Medical Associates, LLC	NM	General Practice Physician	$0	$41.4M

Breatheamerica Albuquerque, Inc. — Billing Profile & Reimbursement Data

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Breatheamerica Albuquerque, Inc. — 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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