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.

El Paraiso (NPI 1982814620)

Field	Value
Entity Type	Organization
Organization	El Paraiso
Address	413 Los Lentes Ne
City	Los Lunas
State	NM
ZIP	87031
Taxonomy	Case Management Agency
NPI Enumerated	May 23, 2007

Payer Source	Total Paid
Medicaid	$40.9M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-only billing entity: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $40.9M, indicating heavy reliance on state Medicaid payments for its operating revenue. The absence of Medicare claims suggests its services and contracts are focused on Medicaid-eligible populations rather than dual-eligible or Medicare-only beneficiaries.

Revenue is highly concentrated in a few service lines: the precomputed top three Medicaid codes account for 91.2% of this provider's total Medicaid revenue. Those three are 99509 ($27.5M, 67.3% of Medicaid revenue), S5125 ($6.3M, 15.4%), and T1019 ($3.5M, 8.5%), which together create a narrow revenue base centered on a small set of home- and personal-care services.

The code mix and descriptions indicate the operation is focused on hands-on, home-based personal care and attendant services consistent with its Case Management Agency taxonomy. 99509 is a home health/ADL visit code, S5125 reimburses attendant care per 15 minutes, and T1019 is personal care per 15 minutes; together these codes point to a business model oriented to direct personal assistance, activities-of-daily-living support, and case coordination in community settings.

Competitive standing on the largest single code (99509) is moderate but not dominant statewide: 99509 generates $27.5M and ranks #17 of 82 providers in-state (80th percentile; typical, unremarkable volume for this code). This placement suggests EL PARAISO is an important regional provider for ADL/home-health visits but is not a statewide market leader in that service.

S5125 and T1019 reveal a split competitive footprint across attendant and personal care lines: S5125 ($6.3M) ranks #10 of 45 in-state (80th percentile; typical, unremarkable volume), indicating relatively strong positioning in attendant care, while T1019 ($3.5M) ranks #59 of 89 (34th percentile; typical, unremarkable volume), showing a weaker presence in the broader personal-care per-15-minute market. This divergence implies the provider is comparatively more active or successful in attendant-care billing than in the wider personal-care code set.

There is modest diversification beyond the top three: G9006 (coordinated care fee, home monitoring) appears with $3.4M (8.4% of Medicaid revenue) and ranks #16 of 79 (81th percentile; typical, unremarkable volume), suggesting EL PARAISO also bills for coordinated/home monitoring activities in addition to direct hands-on services. Smaller lines such as S5110 (home care training) and S9999 (sales tax) together represent de minimis shares of revenue, indicating limited ancillary service income.

The provider has an established enrollment history, with an NPI enumerated on 2007-05-23 (~19 years ago), which supports interpretation of its concentrated Medicaid footprint as the result of sustained operations rather than a very new entrant. Given its tenure and concentrated code mix, strategic shifts or payer mix changes could meaningfully affect overall revenue due to the heavy dependence on a few Medicaid codes.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	79,580	$350	$27.5M
S5125	Attendant care services; per 15 minutes	65,070	$100	$6.3M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	55,950	$60	$3.5M
G9006	Coordinated care fee, home monitoring	16,050	$210	$3.4M
S5110	Home care training, family; per 15 minutes	390	$290	$115K
S9999	Sales tax	2,370	$20	$47.4K

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

El Paraiso — 0 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99509	A home health provider, such as a registered nurse, or a non nursing practitioner, visits a patient to provide help with activities of daily living, or ADLs, and self care.	17	80	20,990	$310	$16.4M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	59	90	92,900	$70	$13.3M
S5125	Attendant care services; per 15 minutes	10	50	10,600	$100	$4.3M
G9006	Coordinated care fee, home monitoring	16	80	3,840	$190	$2M
S5110	Home care training, family; per 15 minutes	17	40	340	$200	$202.4K
S9999	Sales tax	39	160	800	$10	$25.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
La Vida Felicidad, Inc.	NM	Developmentally Disabled Services Day Training Agency	$0	$21.1M
Adaptive Personal Care Services	NM	Home Health Agency	$0	$19.9M
Tasker Hatch Rowan LLC	NM	Dentist	$0	$8.6M
Bella Vida Health Care And Medi Spa	NM	Health Service Clinic/Center	$0	$7.2M
Full Circle Recovery	NM	Community/Behavioral Health Agency	$0	$6.1M
Paradigm Physical Therapy And Wellness Inc	NM	Physical Therapist	$0	$5.7M
Bio-medical Applications Of New Mexico, Inc.	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.8M
Senior Living Systems Inc.	NM	Assisted Living Facility	$0	$2.7M
First Choice Community Healthcare, Inc.	NM	Federally Qualified Health Center (FQHC)	$0	$2.7M
Adaptive Non Emergency Transportation Inc.	NM	Non-emergency Medical Transport (VAN)	$0	$2.6M

El Paraiso — Billing Profile & Reimbursement Data

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El Paraiso — 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