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.

Hesham Sirsy Md Ltd (NPI 1982763108)

Hesham Sirsy Md Ltd is a pediatrics physician provider located in Henderson, Nevada. This profile covers 0 Medicare and 44 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	Hesham Sirsy Md Ltd
Address	10950 S Eastern Ave
City	Henderson
State	NV
ZIP	89052
Taxonomy	Pediatrics Physician
NPI Enumerated	December 6, 2006

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

44 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…	9,510	$60	$551.6K
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…	4,250	$80	$357.3K
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.	4,970	$40	$194K
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…	2,340	$80	$177.7K
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…	2,010	$90	$174.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	940	$90	$83.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,810	$30	$78.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	550	$100	$52.3K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	1,290	$30	$40K
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.	1,130	$20	$16.9K

Showing 1–10 of 44

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

Hesham Sirsy Md Ltd — 1 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	351	430	180	$130	$158K
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…	235	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…	135	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…	45	300	280	$80	$103.8K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	25	30	950	$60	$100.7K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	207	230	160	$70	$99.1K
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…	50	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.	45	310	410	$40	$95K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	57	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.	52	220	130	$80	$57K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Platinum Hospitalists LLP	NV	Hospitalist Physician	$0	$38.8M
Urgent Care Nevada, LLC	NV	Urgent Care Clinic/Center	$0	$34.9M
Dignity Health	NV	General Acute Care Hospital	$0	$18.7M
Behavioral Health Solutions LLC	NV	Community/Behavioral Health Agency	$0	$11.4M
Lamotte Pediatrics, LLP	NV	Pediatrics Physician	$0	$9.4M
Minghsun Liu Md PC	NV	Infectious Disease Physician	$0	$5.1M
Optimized Management LLC	NV	Clinical Social Worker	$0	$5M
Misch/hyun/hodapp Healthcare, LLP	NV	Pediatrics Physician	$0	$4.5M
Ellsworth Cox Pediatric Dentistry LLC	NV	Pediatric Dentistry	$0	$3.7M
Total Infusion Care LLC	NV	Home Infusion Therapy Pharmacy	$0	$3.1M

Hesham Sirsy Md Ltd — Billing Profile & Reimbursement Data

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Hesham Sirsy Md Ltd — 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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