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.

Pulmonary Associates, Inc. (NPI 1952436115)

Pulmonary Associates, Inc. is a pulmonary disease physician provider located in Las Vegas, Nevada. This profile covers 0 Medicare and 32 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	Pulmonary Associates, Inc.
Address	2000 Wellness Way
City	Las Vegas
State	NV
ZIP	89106
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	February 21, 2007

Payer Source	Total Paid
Medicaid	$8.5M
Medicare	$0

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	53,350	$60	$3.4M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	63,660	$40	$2.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11,490	$120	$1.4M
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…	6,940	$50	$354.1K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,350	$90	$208.8K
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…	4,920	$40	$206.6K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	430	$200	$86.5K
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…	3,900	$20	$70.2K
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…	260	$180	$47.1K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	1,170	$40	$45.5K

Showing 1–10 of 32

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

Pulmonary Associates, Inc. — 5 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	40	90	190	$160	$332.4K
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.	44	50	430	$270	$299.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	470	380	$70	$281.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9	430	500	$40	$214.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11	430	180	$130	$158K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	59	140	690	$40	$145.2K
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…	154	2,250	290	$60	$138K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	63	150	460	$20	$119.6K
94618	The provider performs pulmonary stress testing to evaluate lung function and to diagnose certain lung disorders. The stress component may include a six–minute walk test or other form of exercise.	4	10	220	$30	$116.2K
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…	237	2,480	330	$50	$107.6K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Syed Akbarullah	NV	Pulmonary Disease Physician	$155.8K	$302.1K
Jan Pring	NV	Pulmonary Disease Physician	$313.1K	$38.8K
Kevin Tsui	NV	Pulmonary Disease Physician	$254.6K	$39.3K
Simhean Lee	NV	Allergy Physician	$222.6K	$2.1K
Paul Stewart	NV	Pulmonary Disease Physician	$116.4K	$92.2K
Lloyd Del Mundo	NV	Pulmonary Disease Physician	$127.6K	$58.8K
Suresh Khilnani	CO	Pulmonary Disease Physician	$176.9K	$0
Jerome Hruska	NV	Pulmonary Disease Physician	$136.5K	$2.5K
Joel Orevillo	NV	Pulmonary Disease Physician	$120.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clark County Department Of Family Services	NV	Case Management Agency	$0	$166.5M
Shadow Emergency Physicians PLLC	NV	Emergency Medicine Physician	$0	$75.2M
Valley Hospital Medical Center	NV	General Acute Care Hospital	$0	$47M
Southwest Medical Associates, Inc	NV	Diagnostic Radiology Physician	$418.3K	$15.8M
Las Vegas Paiute Tribe Health & Human Services	NV	General Practice Physician	$0	$13.6M
Fresenius Medical Care West Sahara, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.2M
Bridge Counseling Associates, Inc	NV	Community/Behavioral Health Agency	$0	$12.1M
Iriye Medical Group PLLC	NV	Maternal & Fetal Medicine Physician	$0	$11.9M
Janda, Mahajan & Balsiger PLLC	NV	Neurology Physician	$0	$10.5M
Behavioral Health Institute Inc (singh) PC	NV	Addiction Medicine (Family Medicine) Physician	$0	$9.8M

Pulmonary Associates, Inc. — Billing Profile & Reimbursement Data

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Pulmonary Associates, 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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