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.

Otero County Hospital Association (NPI 1861450579)

Key Findings

Field	Value
Entity Type	Organization
Organization	Otero County Hospital Association
Address	2669 Scenic Dr
City	Alamogordo
State	NM
ZIP	88310
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 2, 2006

Payer Source	Total Paid
Medicaid	$73.2M
Medicare	$0

This provider is effectively single-payer in the available dataset: there is no Medicare billing on file while Medicaid revenue totals $73.2M, so all reported federal fee-for-service activity in our dataset is concentrated in Medicaid rather than split between Medicare and Medicaid. Analysts should treat comparisons or benchmarks that assume a Medicare presence as inapplicable for this entity.

Revenue concentration within Medicaid is high: the precomputed top-3 Medicaid codes by revenue — 99214, 99284, and G0463 — account for 39.1% of the provider’s total Medicaid revenue. Individually those codes generate $8.6M (99214, 16.7%), $5.9M (99284, 11.4%), and $5.7M (G0463, 11.1%) of Medicaid revenue, indicating a meaningful dependence on ambulatory E/M and hospital outpatient clinic services.

The code mix points to a hybrid acute-care hospital operating a busy emergency department and extensive outpatient clinic/ambulatory care. High-volume E/M codes such as 99214 (109.3K claims), G0463 (69.2K claims), and the ED E/M codes 99284 (27.6K claims) and 99285 (15.6K claims) show the facility performs both office-level established-patient visits and moderate-to-high acuity ED evaluations at scale. This combination is consistent with a general acute care hospital that routes significant patient flow through ED and hospital outpatient clinic channels.

Competitive standing in-state is concentrated and, for some ambulatory codes, dominant: 99214 ranks #4 of 963 in-state (100th percentile; extreme outlier, far above typical state volume for this code), and 99213 ranks #9 of 932 (99th percentile; notably above typical state volume). These rankings indicate the provider is a major statewide outlier for established outpatient E/M visits, suggesting market leadership in ambulatory evaluation and management volume.

Emergency department activity is sizable but more typical compared with peers: 99284 ($5.9M, 11.4%) ranks #22 of 76 (72th percentile), 99285 ($4.4M, 8.6%) ranks #17 of 71 (77th percentile), and 99283 ($4.1M, 8.0%) ranks #21 of 84 (76th percentile). In plain terms, the ED generates substantial revenue but its volumes place it in the mid-to-upper range of state peers rather than as an extreme outlier, indicating heavy ED throughput without the same outsized dominance seen in some ambulatory E/M codes.

Ancillary services are well-represented and contribute materially to Medicaid revenue, demonstrating on-site imaging and laboratory capacity. Notable items include 74177 (CT abdomen/pelvis with contrast) at $2.4M and 7.2K claims (4.6% of Medicaid revenue), 70450 (CT head without contrast) at $1.5M and 7.7K claims (2.8%), 80053 (CMP) at $1.2M and 58.2K claims (2.2%), and 85025 (CBC) at $744.8K and 62.1K claims (1.4%). High-volume diagnostic testing and imaging plus respiratory testing codes such as 87635 ($737.4K; 97th percentile, notably above typical) and 87502 ($730.3K; 93th percentile, notably above typical) underline robust lab throughput for infectious and routine testing.

Procedural and observation services appear as consistent revenue contributors, signaling inpatient/observation and procedural capacity beyond basic clinic visits. Examples include surgical debridement 11043 ($962.2K, 1.9%) which ranks #1 of 8 in-state (100th percentile; notably above typical state volume for this code), observation G0378 ($815.3K, 1.6%), and a suite of infusion/IV administration codes 96374/96375/96365 that together reflect repeated IV medication and infusion activity. These code patterns support a service mix that includes bedside procedures, wound care, observation stays, and infusion treatments.

This NPI has an established tenure in public records (NPI enumerated 2006-05-02, ~20 years ago), and combined with the heavy Medicaid dependence ($73.2M) and concentrated top-code share (top 3 = 39.1%), the provider’s financial profile is centrally anchored to state Medicaid volume and the hospital’s ambulatory and ED throughput. For payers and analysts, that combination implies performance and contract negotiations will be particularly sensitive to Medicaid policy and regional outpatient/ED referral patterns since there is no Medicare offset reported in the dataset.

Medicaid: Complete Services Breakdown

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

416 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…	109,310	$80	$8.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	27,640	$210	$5.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	69,170	$80	$5.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	15,620	$280	$4.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	26,480	$160	$4.1M
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…	79,320	$50	$4.1M
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.	7,190	$340	$2.4M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	7,650	$190	$1.5M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	22,630	$60	$1.3M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	6,730	$180	$1.2M

Showing 1–10 of 416

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

Otero County Hospital Association — 4 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

416 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	22	80	12,050	$160	$3.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	17	70	6,920	$210	$3.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	5	40	3,670	$80	$3.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	21	80	10,650	$130	$2.4M
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.	12	60	3,070	$210	$1.4M
G0378	Hospital observation service, per hour	7	40	1,000	$400	$1M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	12	60	2,820	$110	$799.5K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	6	50	7,300	$60	$737.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	20	140	130	$220	$568.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7	20	750	$90	$524.9K

Showing 1–10 of 416

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Mrunal Tailor	NM	Diagnostic Radiology Physician	$897.5K	$0
Masoud Shiehmorteza	NM	Diagnostic Radiology Physician	$773.7K	$0
Brenda Baker	AZ	Family Nurse Practitioner	$545.6K	$0
Aaron Losey	NM	Diagnostic Radiology Physician	$518K	$0
Jason Ross	TX	Diagnostic Radiology Physician	$482.4K	$0
Robert Graor	NM	Cardiovascular Disease Physician	$443.3K	$7.7K
John Hennessee	OK	Psychiatry Physician	$415.1K	$5.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
American Medical Response Ambulance Service Inc	NM	Ambulance	$3M	$23.9M
Presbyterian Medical Services	NM	Federally Qualified Health Center (FQHC)	$0	$11M
Fillmore Eye Clinic Incorporated	NM	Ophthalmology Physician	$0	$6.2M
Ben Archer Health Center	NM	Federally Qualified Health Center (FQHC)	$0	$5.2M
Rail Junction Emergency Physicians LLC	NM	Emergency Medicine Physician	$0	$4.4M
New Mexico Em-i Medical Services, P.C	NM	Nurse Practitioner	$0	$4.4M
Zia Therapy Center, Inc.	NM	Clinic/Center	$0	$4.3M
Fillmore Eye Clinic Incorporated	NM	Ambulatory Surgical Clinic/Center	$2.6M	$1.3M
Four Corners Emergency Physicians PLLC	NM	Emergency Medicine Physician	$0	$3.2M
Alamogordo Physical Therapy & Wellness Center, Inc	NM	Physical Therapist	$0	$2.9M

Otero County Hospital Association — Billing Profile & Reimbursement Data

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Otero County Hospital Association — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References