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

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

Affinia Healthcare (NPI 1003824293)

Field	Value
Entity Type	Organization
Organization	Affinia Healthcare
Address	2220 Lemp Ave
City	Saint Louis
State	MO
ZIP	63104
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 3, 2006

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

71 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…	24,790	$60	$1.6M
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…	8,280	$100	$836.2K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	1,070	$240	$260K
H0049	Alcohol and/or drug screening	13,210	$10	$171.7K
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,…	3,370	$40	$138K
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…	1,390	$80	$115.4K
H1001	Prenatal care, at-risk enhanced service; antepartum management	1,090	$100	$109.9K
H1000	Prenatal care, at-risk assessment	1,100	$100	$104.3K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	4,300	$20	$98.9K
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…	1,210	$80	$95.9K

Showing 1–10 of 71

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Affinia Healthcare — 10 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

71 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	225	240	1,740	$40	$353.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	302	320	980	$40	$352.7K
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…	120	3,170	230	$70	$128.1K
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…	63	4,310	300	$60	$110.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	394	440	250	$70	$71.8K
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…	73	680	280	$90	$65.3K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	10	260	180	$60	$61.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	178	420	90	$100	$60.2K
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…	79	640	210	$90	$59.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	769	1,060	250	$40	$57.7K

Showing 1–10 of 71

Related Providers

Other providers that share a Tax Identification Number (TIN) with Affinia Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Affinia Healthcare	MO	Federally Qualified Health Center (FQHC)	$0	$5.7M
Affinia Healthcare	MO	Federally Qualified Health Center (FQHC)	$0	$3.6M
Gary Goodman	MO	Pediatric Allergy/Immunology Physician	$69.1K	$0
Theodore Sullivan	MO	Optometrist	$28K	$17.7K
Julia Stelmach	MO	Audiologist	$9.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ssm Cardinal Glennon Children's Hospital	MO	Children's Hospital	$0	$52.6M
Ssm-sluh Inc	MO	General Acute Care Hospital	$0	$20.6M
Ssm Health Care Group	MO	Internal Medicine Physician	$0	$17.3M
Levent Akduman	MO	Ophthalmology Physician	$3.1M	$1.4M
Southside Wellness Center Inc	MO	Personal Care Attendant	$0	$3.8M
Shamseldeen Mahmoud	MO	Neuroradiology Physician	$109.5K	$474K
Kristin Smith	MO	Dermatopathology Physician	$451.5K	$12.4K
Nicole Burkemper	MO	Dermatology Physician	$237K	$51.7K
M Yadira Hurley	MO	Dermatopathology Physician	$242K	$38.4K
Abdalla Hassan	MO	Interventional Cardiology Physician	$244K	$8.1K

Affinia Healthcare — Billing Profile & Reimbursement Data

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Affinia Healthcare — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References