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

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

Afton Communiy Day, Inc. (NPI 1043703572)

Field	Value
Entity Type	Organization
Organization	Afton Communiy Day, Inc.
Address	3743 Red River Dr
City	Lexington
State	KY
ZIP	40517
Taxonomy	Adult Day Care Clinic/Center
NPI Enumerated	June 9, 2018

Payer Source	Total Paid
Medicaid	$56M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operator: Total Medicare revenue is none and Total Medicaid revenue is $56M, so all reported lifetime billing on file derives from Medicaid rather than Medicare. The absence of Medicare billing suggests the entity’s services and billing focus align with Medicaid-covered long-term supports and services rather than fee-for-service Medicare clinical procedures.

Revenue is highly concentrated in a very small set of codes: the precomputed top 3 Medicaid codes account for 99.1% of this provider’s total Medicaid revenue, with S5108 alone generating $53.5M (95.6% of the provider’s Medicaid revenue). S5170 contributes $1.3M (2.2%) and S5100 contributes $716.5K (1.3%), indicating the provider’s financial performance is overwhelmingly tied to a single dominant service line.

The operational footprint implied by the code mix centers on home-based supports and meal delivery rather than traditional center-based day services: S5108 (home care training to home care client, per 15 minutes) is the principal revenue driver, and S5170 (home delivered meals, per meal) is the secondary line. By contrast, S5100 (day care services, adult, per 15 minutes) is a small share of revenue, suggesting either limited in-center capacity or a strategic emphasis on home-based offerings within an Adult Day Care Clinic/Center taxonomy.

Competitive standing on the dominant code is substantial but not top-ranked statewide: S5108 is $53.5M and the provider ranks #19 of 101 providers in-state (82th percentile; typical, unremarkable volume for this code), which characterizes the provider as an important regional participant in home care training but not the largest statewide operator for that service. The dataset’s label "typical, unremarkable volume for this code" underscores that, while this provider depends on S5108 for revenue, similar volumes are also common across many in-state peers.

The provider shows a strong statewide position in meal delivery services: S5170 accounts for $1.3M (2.2% of Medicaid revenue) and ranks #6 of 56 providers in-state (91th percentile; typical, unremarkable volume for this code). This ranking indicates a relatively prominent placement among in-state meal-delivery providers, consistent with a complementary service offering to the dominant home-care training line.

Core day-center services appear to be a modest part of the business: S5100 is $716.5K (1.3% of Medicaid revenue) and ranks #69 of 102 providers in-state (33th percentile; typical, unremarkable volume for this code), implying limited market share for billed adult day care services relative to peers. This contrast between low S5100 volume and dominant S5108 billing suggests the provider may operate more as a home-supports organization than a high-volume physical adult day center.

Ancillary services such as respite and case management are present but small relative to total Medicaid revenue: T1005 (respite care services) generated $365.8K (0.7%) and ranks #39 of 81 (53th percentile; typical, unremarkable volume), while T1016 (case management) generated $143.1K (0.3%) and ranks #47 of 63 (26th percentile; typical, unremarkable volume). These figures indicate complementary care functions that support the primary home-care training and meal services but do not materially diversify revenue.

The provider has an established Medicaid billing history dating to its NPI enumeration on 2018-06-09 (~8 years ago), which provides multiple years for program development and payer relationships. Given the extreme revenue concentration (99.1% from top 3 codes and 95.6% from a single code), any changes in Medicaid reimbursement policy or utilization for S5108 would likely have outsized financial impact on this organization’s revenues.

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5108	Home care training to home care client, per 15 minutes	230,780	$230	$53.5M
S5170	Home delivered meals, including preparation; per meal	83,450	$20	$1.3M
S5100	Day care services, adult; per 15 minutes	10,380	$70	$716.5K
T1005	Respite care services, up to 15 minutes	3,480	$110	$365.8K
T1016	Case management, each 15 minutes	1,110	$130	$143.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Afton Communiy Day, Inc. — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5108	Home care training to home care client, per 15 minutes	19	100	43,820	$140	$16.6M
S5100	Day care services, adult; per 15 minutes	69	100	16,270	$70	$1.9M
T1016	Case management, each 15 minutes	47	60	3,410	$120	$970.5K
T1005	Respite care services, up to 15 minutes	39	80	2,880	$70	$799.2K
S5170	Home delivered meals, including preparation; per meal	6	60	5,170	$10	$342.6K

Nearby Providers

Other providers in the same ZIP code as Afton Communiy Day, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky Medical Services Foundation, Inc	KY	Internal Medicine Physician	$0	$110.4M
Bluegrass Area Development District	KY	Case Management Agency	$0	$75.4M
Bluegrass Area Development District	KY	Supports Brokerage Agency	$0	$65.3M
Baptist Health Medical Group Inc	KY	Nurse Practitioner	$0	$54.1M
Families Hope, LLC	KY	Adult Care Home Facility	$0	$19.4M
Central Kentucky Radiology PLLC	KY	Diagnostic Radiology Physician	$0	$17.6M
Lionheart Trauma Support Services, LLC	KY	Clinical Social Worker	$0	$3.5M
Johannes Evans	KY	Ophthalmology Physician	$291.9K	$588.5K
David Blandford	KY	Ophthalmology Physician	$260.1K	$58.1K
William Curtis	KY	Ophthalmology Physician	$216.2K	$84.2K

Afton Communiy Day, Inc. — Billing Profile & Reimbursement Data

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Afton Communiy Day, Inc. — 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