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

Why is the Medicaid comparison limited to Nevada 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. Nevada (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.

Harold Zilberman M D Chtd (NPI 1942364054)

Key Findings

Field	Value
Entity Type	Organization
Organization	Harold Zilberman M D Chtd
Address	3201 S Maryland Pkwy Ste 608
City	Las Vegas
State	NV
ZIP	89109
Taxonomy	Pediatrics Physician
NPI Enumerated	December 21, 2006

Payer Source	Total Paid
Medicaid	$14.3M
Medicare	$0

This provider is effectively a single-payer Medicaid practice: there is no Medicare billing on file and lifetime Medicaid revenue is $14.3M. The absence of Medicare activity combined with substantial Medicaid receipts indicates the practice’s operational footprint is concentrated on pediatric Medicaid populations rather than mixed Medicare/Medicaid panels.

Revenue is highly concentrated in a small set of codes: the top three Medicaid codes (99213, 90460, 99214) account for 56.9% of this provider's total Medicaid revenue. Those three codes individually generated $2.9M (99213, 20.3%), $2.6M (90460, 18.4%), and $2.6M (99214, 18.2%), which points to material business risk if volumes or rates for these services changed.

The code mix points to a high-volume pediatric primary care operation with large immunization throughput and routine office E/M visits: 99213 and 99214 are the largest E/M drivers, and 90460 (single vaccine administration) is the single largest immunization code by rank and revenue. High volumes in preventive medicine codes (99391, 99392, 99393) and well-child visit codes further support that the practice is organized around scheduled well-child care and vaccination delivery.

Competitive standing within Nevada is dominant for several pediatric services. 90460 ranks #1 of 310 providers in-state (100th percentile; extreme outlier), 99213 ranks #13 of 2476 (100th percentile; extreme outlier), and 99214 ranks #27 of 2254 (99th percentile; extreme outlier), indicating this provider operates at a volume level far above typical state peers for key pediatric visit and vaccine codes.

The practice shows unusually high same-day and walk-in visit activity: 99058 appears with 24.6K claims, $417.4K revenue and ranks #1 of 67 providers in-state (100th percentile; extreme outlier). This pattern suggests deliberate capacity for urgent or same-day office care in addition to scheduled well visits, shaping scheduling, staffing, and front-desk operations.

Preventive and well-child services are a clear focus: 99391 ($1.6M, 11.5% of Medicaid revenue) ranks #4 of 296 (99th percentile; extreme outlier), 99392 ($1.6M, 11.2%) ranks #2 of 303 (100th percentile; extreme outlier), and 99393 ($1.0M, 7.3%) ranks #3 of 271 (99th percentile; extreme outlier). These high ranks and revenues for age-specific preventive codes indicate a systematic emphasis on periodic health checks across pediatric age groups.

In-office point-of-care testing and screening accompany the clinical volume: 36416 shows 12.5K claims ($37.6K, rank #2 of 103, 99th percentile; extreme outlier) and 96110 shows 6.6K claims ($39.9K, rank #7 of 167, 96th percentile; notably above typical). Respiratory and infectious disease testing (87637, 87804, 87635) also appear in the top codes, supporting a practice workflow that integrates diagnostic testing with clinical visits.

The provider has long tenure: NPI enumerated on 2006-12-21 (~20 years ago). Long-term enumeration plus the tens of thousands of claims for leading codes (e.g., 50.5K claims for 99213 and 49.3K claims for 90460) signal an established, high-volume pediatric operation with the administrative capacity to process large Medicaid claim volumes.

Medicaid: Complete Services Breakdown

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

67 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	50,530	$60	$2.9M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	49,350	$50	$2.6M
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…	30,000	$90	$2.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	19,900	$80	$1.6M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	18,200	$90	$1.6M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11,930	$90	$1M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,030	$100	$482.7K
99058	The provider renders emergency services to a patient in the provider’s office during regular office hours without an appointment and ahead of other scheduled patients.	24,550	$20	$417.4K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	3,950	$80	$296.1K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	5,060	$20	$96.1K

Showing 1–10 of 67

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Nevada providers billing the same CPT/HCPCS codes.

Claims Volume vs. Nevada Distribution

Harold Zilberman M D Chtd — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada median

67 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	27	2,250	290	$60	$138K
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…	13	2,480	330	$50	$107.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4	300	280	$80	$103.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2	300	240	$80	$97.1K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1	310	410	$40	$95K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2	20	610	$50	$73.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3	270	170	$80	$70.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5	220	130	$80	$57K
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…	746	780	90	$100	$46.6K
94667	The provider performs chest physical therapy using manual methods to mobilize the patient’s lung secretions.	11	20	140	$20	$46.1K

Showing 1–10 of 67

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunrise Hospital And Medical Center, LLC	NV	General Acute Care Hospital	$0	$85.9M
Fremont Emergency Services Scherr Ltd	NV	Emergency Medicine Physician	$0	$20.9M
Sunrise Hospital And Medical Center, LLC	NV	General Acute Care Hospital	$0	$17.1M
Sanjay Kandoth Md PC	NV	Pediatrics Physician	$0	$14.6M
Sdmi, LLC	NV	Diagnostic Radiology Physician	$0	$14.3M
Radiology Specialists Ltd Marasso-miller	NV	Diagnostic Radiology Physician	$0	$13.9M
1st Love & Life Caregivers, LLC	NV	In Home Supportive Care Agency	$0	$10.8M
Childrens Lung Specialists	NV	Pediatric Pulmonology Physician	$0	$8.6M
Jlk Home Care, Inc	NV	In Home Supportive Care Agency	$0	$5.1M
Elsa Home Care Inc	NV	In Home Supportive Care Agency	$0	$4.8M

Harold Zilberman M D Chtd — Billing Profile & Reimbursement Data

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Harold Zilberman M D Chtd — 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

Nearby Providers

Frequently Asked Questions

References