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

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

Richard Rivera Mdpc (NPI 1992973473)

Richard Rivera Mdpc is a health service clinic/center provider located in Pueblo, Colorado. This profile covers 0 Medicare and 53 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	Richard Rivera Mdpc
Address	1080 Chinook Ln
City	Pueblo
State	CO
ZIP	81001
Taxonomy	Health Service Clinic/Center
NPI Enumerated	February 18, 2008

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

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

53 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…	35,130	$60	$2.1M
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…	11,170	$90	$971.6K
99203	The provider sees a new 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 provider…	2,540	$80	$211.1K
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…	1,130	$130	$145.6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	3,270	$40	$124.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,270	$90	$110.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	5,930	$10	$77.1K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	6,270	$10	$75.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	4,070	$20	$73.3K
J1050	Injection, medroxyprogesterone acetate, 1 mg	960	$70	$65.4K

Showing 1–10 of 53

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Richard Rivera Mdpc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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	2,520	330	$100	$352K
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…	173	2,630	430	$90	$268.2K
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…	120	240	550	$110	$208.5K
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…	126	260	380	$100	$161.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	95	290	160	$110	$111.1K
99203	The provider sees a new 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 provider…	61	880	110	$80	$64.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	27	280	110	$120	$60.1K
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…	89	990	90	$120	$57.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	197	260	160	$30	$24.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	31	80	80	$50	$23.9K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Solutions	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$118.6M
Argus Home Care Inc	CO	Home Health Agency	$0	$24.9M
Oakshire Gardens	CO	Assisted Living Facility	$0	$14.8M
Pueblo Community Health Center Inc	CO	Federally Qualified Health Center (FQHC)	$0	$7.7M
Roth Medical Inc	CO	Durable Medical Equipment & Medical Supplies	$0	$7M
Pueblo Community Health Center Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$6M
Family & Kids Dental PC	CO	General Practice Dentistry	$0	$4.9M
Rocky Mountain Eye Center Inc A Colorado Provider Network	CO	Ophthalmology Physician	$0	$3.9M
Pueblo Ambulatory Surgery Center LLC	CO	Ambulatory Surgical Clinic/Center	$273K	$968K
Skyline Surgery Center, LLC	CO	Ambulatory Surgical Clinic/Center	$358.4K	$238K

Richard Rivera Mdpc — Billing Profile & Reimbursement Data

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Richard Rivera Mdpc — 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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