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.

Pokroy Medical Group Of Nevada, Ltd. (NPI 1992809412)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pokroy Medical Group Of Nevada, Ltd.
Address	653 N Town Center Dr Ste 112
City	Las Vegas
State	NV
ZIP	89144
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

POKROY MEDICAL GROUP OF NEVADA is effectively a Medicaid-centric practice: there is no Medicare billing on file while lifetime Medicaid revenue is $33.7M, indicating the provider’s financial footprint is concentrated entirely in the Medicaid payer channel. This makes Medicaid the dominant payer for any network or contracting analysis of this entity.

Revenue is highly concentrated in a few codes: the top three Medicaid codes 99283, 99469, and 99284 account for 48.3% of the provider’s total Medicaid revenue. In dollar terms those codes are 99283 ($6.5M, 19.6% of Medicaid revenue), 99469 ($5.3M, 15.8% of Medicaid revenue), and 99284 ($4.3M, 12.9% of Medicaid revenue), so nearly half of Medicaid dollars flow through a small set of ED and neonatal critical-care codes.

The code mix indicates a dual operational focus: large emergency department volume (high counts for 99283 with 114.2K claims and 99284 with 41.2K claims) combined with significant neonatal and NICU activity (high-revenue neonatal codes such as 99469, 99480, 99479, 99472 and 99468 appear prominently). This pattern is consistent with a practice providing both acute emergency evaluation services and high-intensity neonatal critical care and follow-up for low birth weight and critically ill infants.

POKROY MEDICAL GROUP is a dominant statewide provider for multiple neonatal-specific codes: 99469 ranks #1 of 5 in-state (100th percentile; notably above typical state volume), 99480 ranks #1 of 22 (100th percentile; extreme outlier), and 99479 ranks #1 of 19 (100th percentile; extreme outlier). Several other neonatal and inpatient E/M codes also rank at or near the top of state lists (for example 99238 ranks #1 of 161, 100th percentile; extreme outlier), signaling outsized market share in neonatal/NICU services within Nevada.

Emergency and hospital E/M services are also a standout part of the business: 99283 (114.2K claims, $57 avg paid/claim, $6.5M revenue; 19.6% of Medicaid revenue) is an extreme outlier in-state (99th percentile) and 99284 (41.2K claims, $104 avg paid/claim, $4.3M revenue; 12.9% of Medicaid revenue) ranks in the 96th percentile. These high claim volumes and percentile positions show the provider contributes substantial ED throughput relative to in-state peers and is a major source of acute evaluation services billed to Medicaid.

State-level competitive signals vary by code size: several high-ranked codes are described as "extreme outlier" or "notably above typical" (e.g., 99283, 99480, 99479), while other high-percentile codes appear in smaller peer pools and are labeled "typical, unremarkable" despite top ranks (for example 99472 is 100th percentile but noted as typical). This suggests the provider’s leadership position is clearest in high-volume neonatal and ED codes, whereas interpretation of 100th-percentile rankings in small-code cohorts should account for limited comparator counts.

The provider’s NPI has been enumerated since 2006-09-13 (~20 years ago), indicating long tenure in the market; combined with the concentrated Medicaid revenue and repeated top-state rankings, the practice appears to be an established neonatal and acute-care participant in Nevada’s Medicaid ecosystem.

For payers and network analysts, the combination of no Medicare billing, $33.7M in Medicaid revenue, and high concentration in both ED E/M codes and neonatal critical-care codes (top three codes = 48.3% of Medicaid revenue) points to contract and utilization oversight needs that are Medicaid-focused and oriented around ED throughput and NICU-level services rather than Medicare-oriented ambulatory lines of business.

Medicaid: Complete Services Breakdown

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

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	114,250	$60	$6.5M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	15,840	$330	$5.3M
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.	41,220	$100	$4.3M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	32,270	$100	$3.4M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	23,110	$110	$2.5M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	6,540	$350	$2.3M
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…	14,160	$90	$1.3M
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…	18,470	$60	$1.2M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	25,600	$40	$947.2K
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…	9,120	$90	$839.4K

Showing 1–10 of 56

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

Pokroy Medical Group Of Nevada, Ltd. — 14 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

56 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	60	$330	$1.3M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	60	$340	$761.8K
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.	129	350	240	$110	$685.4K
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.	15	400	200	$90	$442.5K
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…	22	90	190	$160	$332.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	4	390	200	$60	$289.8K
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…	44	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…	35	430	500	$40	$214.4K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	1	20	90	$100	$200.7K
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…	25	430	180	$130	$158K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ira Schachar	CA	Retina Specialist (Ophthalmology) Physician	$3.9M	$4.1M
Jason Wickens	NV	Ophthalmology Physician	$1.2M	$9.1K
Rodney Hollifield	NV	Ophthalmology Physician	$542.3K	$0
Megan Hyla	NV	Physician Assistant	$5.2K	$27.5K
Shanti Thirumalai	NV	Neurology with Special Qualifications in Child Neurology Physician	$10.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summerlin Hospital Medical Center L L C	NV	General Acute Care Hospital	$0	$30.3M
Shelin Agrawal And Hyer PLLC	NV	Diagnostic Radiology Physician	$0	$20.4M
Reliant Physicians (kumar) PLLC	NV	Hospitalist Physician	$0	$16.8M
Desert Valley Pediatrics, LLP	NV	Pediatrics Physician	$0	$9.7M
Sunshine Valley Health Care-wesley J. Robertson M.d. Prof. Corp.	NV	Pediatrics Physician	$0	$6.3M
Orthopedic Motion, Inc	NV	Specialist	$0	$3.2M
Amir Z Qureshi Md Ltd	NV	Internal Medicine Physician	$0	$2.4M
Greater Las Vegas Dialysis LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.2M
Retina Consultants Of Nevada LLP	NV	Ophthalmology Physician	$0	$2M
Brian Vicuna	NV	Medical Oncology Physician	$1.8M	$35.9K

Pokroy Medical Group Of Nevada, Ltd. — Billing Profile & Reimbursement Data

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Pokroy Medical Group Of Nevada, Ltd. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References