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

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

Southcentral Foundation (NPI 1083660815)

Field	Value
Entity Type	Organization
Organization	Southcentral Foundation
Address	4341 Tudor Centre Dr Ste 200
City	Anchorage
State	AK
ZIP	99508
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$15M
Medicare	$0

Key Findings

SOUTHCENTRAL FOUNDATION (Multi-Specialty Clinic/Center in ANCHORAGE, AK) has been NPI-enumerated since 2006-05-25 (~20 years ago), indicating long-standing operations in the market. Its recorded payer activity is heavily skewed toward Medicaid, with no Medicare billing on file, signaling a sustained focus on the Medicaid population rather than fee-for-service Medicare cohorts.

This provider reports Total Medicaid revenue of $15M and Total Medicare revenue: none (no Medicare billing on file), making its commercial/payer footprint effectively single-payer in the available claims data. Analysts should treat Medicaid as the operational and revenue driver when modeling contracting leverage or access for this entity.

Revenue is extremely concentrated in a narrow set of ophthalmology codes: the top 3 Medicaid codes account for 96.9% of the provider’s total Medicaid revenue. Those three codes are 92014 ($7.8M, 51.9%), 92004 ($5.9M, 39.6%), and 92015 ($815.5K, 5.4%), which together dominate the revenue profile.

The code mix (92014, 92004, 92015) indicates the organization operates as a high-volume eye-care provider: 92004 is comprehensive ophthalmological evaluation for new patients, 92014 is comprehensive for established patients, and 92015 covers refraction/vision determination. Claim volumes and unit payments underscore this operational focus — 92014 has 13.9K claims at $561 avg paid/claim, 92004 has 9.4K claims at $633 avg paid/claim, and 92015 shows 26.3K claims at $31 avg paid/claim — a pattern consistent with a clinic that performs both high-dollar comprehensive exams and very high-volume refractions.

Across state comparators, SOUTHCENTRAL FOUNDATION is a dominant service provider for its top ophthalmology codes: 92014 ranks #1 of 102 providers in-state (100th percentile; extreme outlier, far above typical state volume), 92004 ranks #1 of 95 providers (100th percentile; extreme outlier), and 92015 ranks #1 of 106 providers (100th percentile; extreme outlier). These rankings mark the provider as a statewide outlier and the likely primary Medicaid eye-care destination in Alaska for these services.

Secondary ophthalmic and imaging codes generate only small shares of Medicaid revenue and show typical participation levels: 92012 produced $193K (1.3% of total Medicaid revenue) and ranks #8 of 26 providers in-state (72th percentile; typical, unremarkable volume), 92002 produced $138.8K (0.9%) and ranks #4 of 16 (80th percentile; typical, unremarkable), and 92250 produced $135.2K (0.9%) and ranks #6 of 23 (77th percentile; typical, unremarkable). These figures suggest the provider’s depth is concentrated in core exams rather than ancillary imaging or lower-volume specialty testing.

Payment-level contrasts reinforce the business model: the two highest-revenue codes pay at materially higher averages ($561 avg for 92014 and $633 avg for 92004) while the top-volume refraction 92015 pays only $31 avg per claim despite 26.3K claims. This mix explains how a relatively small set of service lines can produce the majority of Medicaid revenue and should guide utilization and cost analyses for payers.

For payers and competitors evaluating network strategy, the combination of long tenure (NPI since 2006-05-25), Medicaid-only revenue reporting, and extreme outlier statewide ranks on 92014/92004/92015 indicates a specialized, high-capacity eye-care operation that functions as a major Medicaid provider in Alaska. Contracting, access planning, and capacity assessments for ophthalmology in-state should treat this entity as a principal provider rather than a marginal participant.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	13,890	$560	$7.8M
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	9,390	$630	$5.9M
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	26,310	$30	$815.5K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	410	$470	$193K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	240	$580	$138.8K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	430	$320	$135.2K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	10	$60	$710

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Southcentral Foundation — 3 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	1	100	460	$250	$317.6K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	1	100	350	$260	$254.6K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	8	30	160	$310	$209.3K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	4	20	70	$540	$147.7K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	1	110	1,210	$30	$82.6K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	6	20	140	$80	$19.2K
92133	The provider performs computerized diagnostic imaging of the optic nerve in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both…	8	10	50	$40	$10.2K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southcentral Foundation	AK	Multi-Specialty Clinic/Center	$0	$30.7M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$20.3M
Southcentral Foundation	AK	Rehabilitation Clinic/Center	$0	$17M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$13.4M
Southcentral Foundation	AK	Mental Illness Community Based Residential Treatment Facility	$0	$13.3M
Southcentral Foundation	AK	Primary Care Clinic/Center	$0	$12.5M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$12.1M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$11.1M
Southcentral Foundation	AK	Multi-Specialty Clinic/Center	$0	$11M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$10.2M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alaska Native Tribal Health Consortium	AK	General Acute Care Hospital	$0	$397.1M
Providence Health & Services Washington	AK	General Acute Care Hospital	$0	$161.5M
Southcentral Foundation	AK	Community Health Clinic/Center	$0	$130.3M
Alaska Native Tribal Health Consortium	AK	Transportation Broker	$0	$65.5M
The Arc Of Anchorage	AK	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$50.8M
Good Samaritan Care Services	AK	In Home Supportive Care Agency	$0	$46.1M
Alaska Native Tribal Health Consortium	AK	General Acute Care Hospital	$0	$33.1M
Galen Hospital Alaska, Inc.	AK	General Acute Care Hospital	$0	$31.8M
Anchorage Community Mental Health	AK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$31.7M
Patient Housing At Anmc	AK	General Acute Care Hospital	$0	$31M

Southcentral Foundation — 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