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 Unspecified Location for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Kevin Pacheco (NPI 1881980704)

Field	Value
Entity Type	Individual
Organization	Kevin Pacheco
Address	Edificio Adriatico
City	San Pedro
State	XX (Unspecified Location)
ZIP	11501
Taxonomy	General Practice Physician
NPI Enumerated	June 20, 2011

Payer Source	Total Paid
Medicare	$35.6K
Medicaid	$0

Key Findings

This provider’s Medicare activity is very small in absolute dollars: Total Medicare revenue is $35.6K and there is no Medicaid billing on file, so the profile is effectively single‑payer Medicare in scope rather than a mixed Medicare/Medicaid practice. The lack of any Medicaid billing on file means Medicaid does not currently contribute to this provider’s publicly reported revenue mix.

Revenue is highly concentrated in three emergency/critical‑care codes: 99285 ($26.3K, 73.8%), 99284 ($5.5K, 15.3%), and 99291 ($3.2K, 8.9%) — these three codes together account for 97.9% of this provider’s total Medicare revenue. That concentration indicates the provider’s Medicare business is driven almost entirely by high‑acuity ED evaluation and critical‑care services rather than by routine office visits or primary‑care codes.

The CPT/HCPCS mix implies an emergency/acute care operational focus despite the listed taxonomy of General Practice Physician. The three top codes are emergency department E/M (99285, 99284) and critical care (99291), and an additional entry for 93010 (ECG interpretation, $738, 2.1%) supports an acute care diagnostic workflow consistent with ED or urgent‑care practice rather than longitudinal primary care.

Competitive standing by national rank is modest rather than dominant: 99285 ranks #15227 of 61347 providers nationally (75th percentile; typical, unremarkable volume), 99284 ranks #32842 of 64306 (48th percentile; typical, unremarkable volume), and 99291 ranks #58525 of 71290 (16th percentile; typical, unremarkable volume). Taken together, these ranks suggest the provider operates at typical to below‑typical national volumes for critical care but at slightly above‑median volume for the highest‑acuity ED visits, not as a major national player.

Claim counts reinforce the ED/acute profile: 99285 appears 196 times, 99284 58 times, and 99291 19 times, which aligns with a practice that sees a steady flow of high‑acuity ED encounters and only occasional prolonged critical‑care time. The average paid per claim for these top items ($134 for 99285, $94 for 99284, $166 for 99291) further shows Medicare payments are concentrated in fewer, higher‑acuity encounters.

From a payer‑strategy and business‑risk perspective, the absence of Medicaid billing creates payer concentration risk and limits access to Medicaid patient volume; growth or changes in commercial or Medicare contracting would materially affect the provider’s revenue given the small absolute Medicare total of $35.6K. Analysts should expect that any change in referral patterns or site‑of‑service mix would have an outsized effect because the top three codes drive 97.9% of revenue.

The provider’s NPI was enumerated 2011-06-20 (~15 years ago), indicating an established enrollment history in public programs; however, the limited Medicare dollar volume suggests either a part‑time Medicare panel, a focused ED assignment, or work in a setting where Medicare is a smaller share of overall cash flow. Tenure alone does not imply scale — long enrollment with low reported Medicare revenue is consistent with a practitioner in a non‑traditional Medicare revenue role.

No code in the reported top list is flagged as a statistical outlier in the supplied descriptors: each top code is labeled "typical, unremarkable volume" at its listed percentile (for example, 99285 at the 75th percentile and 99291 at the 16th percentile), so there is no indication from the supplied statistical labels of anomalous billing patterns relative to national peers.

Medicare: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	200	$130	$26.3K
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.	60	$90	$5.5K
99291	Critical 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…	20	$170	$3.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	120	$10	$740

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes. Note: this provider's state, "XX," is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.

View: State1 / 2

Claims Volume vs. Unspecified Location Distribution

Kevin Pacheco — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	182	10	180	$180	$31.7K
93010	134	0	N/A	$N/A	$N/A
99284	158	0	N/A	$N/A	$N/A
99285	119	0	N/A	$N/A	$N/A

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Travis County Emergency Physicians PA	TX	Emergency Medicine Physician	$0	$47.3M
Texas Medicine Resources, LLP	TX	Emergency Medicine Physician	$0	$29.6M
Longhorn Emergency Medical Associates PA	TX	Emergency Medicine Physician	$0	$16.1M
Michael Glassinger	LA	Emergency Medicine Physician	$1.5M	$0
Mustafa Hindi	IL	Emergency Medicine Physician	$107.8K	$744.8K
Christopher Durham	TX	Vascular Surgery Physician	$495.7K	$0
Edward Lucas	FL	Emergency Medicine Physician	$165K	$257.3K
Jody Gerard	CT	Family Medicine Physician	$378.2K	$0
Jim Carmical	AR	Family Medicine Physician	$353.8K	$0
Phillip Glasgow	AR	Family Medicine Physician	$267.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nyu Langone Hospitals	NY	General Acute Care Hospital	$0	$69.8M
Statcare Urgent & Walk In Medical Care PLLC	NY	Urgent Care Clinic/Center	$0	$27.1M
County Of Nassau County Comptroller	NY	Land Ambulance	$4.9M	$12.7M
Harry Staszewski	NY	Hematology & Oncology Physician	$1.2M	$18.3K
Martin Fletcher	NY	Ophthalmology Physician	$1M	$0
Marilyn Chengot	NY	Cardiovascular Disease Physician	$909.9K	$15.1K
Michael Scoma	NY	Infectious Disease Physician	$741.5K	$6.2K
Joseph Germano	NY	Clinical Cardiac Electrophysiology Physician	$656.3K	$56.9K
Saba Abolahrari	NY	Geriatric Medicine (Internal Medicine) Physician	$658.5K	$16.6K
Jonathan Haas	NY	Radiation Oncology Physician	$591.4K	$330

Kevin Pacheco — Billing Profile & Reimbursement Data

Sign up for Kevin Pacheco — Billing Profile & Reimbursement Data policy alerts

Kevin Pacheco — Billing Profile & Reimbursement Data

Sign up for Kevin Pacheco — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References