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

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

5 Star Residential Care (NPI 1023460342)

Field	Value
Entity Type	Organization
Organization	5 Star Residential Care
Address	5024 Kelso St
City	Suffolk
State	VA
ZIP	23435
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	July 11, 2016

Payer Source	Total Paid
Medicaid	$10.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1003	Lpn/lvn services, up to 15 minutes	1,310	$4,420	$5.8M
H2022	Community-based wrap-around services, per diem	1,360	$2,660	$3.6M
H0046	Mental health services, not otherwise specified	2,330	$540	$1.3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

5 Star Residential Care — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	106	140	4,450	$1,150	$15.3M
T1003	Lpn/lvn services, up to 15 minutes	19	30	1,640	$720	$4.8M
H0046	Mental health services, not otherwise specified	346	510	6,100	$190	$2.8M

Nearby Providers

Other providers in the same ZIP code as 5 Star Residential Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Tidewater Community Mental	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$84.4M
Aa&g Group Home,llc.	VA	Developmentally Disabled Services Day Training Agency	$0	$10.8M
Bon Secours Surgery Center At Harbour View, LLC	VA	Ambulatory Surgical Clinic/Center	$3.2M	$226.1K
Snehal Damle	VA	Hematology & Oncology Physician	$1.5M	$0
John Mansoor	VA	Rheumatology Physician	$767.7K	$0
Megan Eshbaugh	VA	Rheumatology Physician	$697.6K	$0
Julianne Orlowski	VA	Rheumatology Physician	$687.7K	$0
Roshan Morbia	VA	Plastic Surgery Physician	$421.2K	$0
Raman Unnikrishnan	VA	Urology Physician	$358.8K	$0
Robert Baer	VA	Dermatology Physician	$338.5K	$0

5 Star Residential Care — Billing Profile & Reimbursement Data

Sign up for 5 Star Residential Care — Billing Profile & Reimbursement Data policy alerts

5 Star Residential Care — Billing Profile & Reimbursement Data

Sign up for 5 Star Residential Care — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References