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

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

Wayne Community Health Centers Inc (NPI 1093816282)

Field	Value
Entity Type	Organization
Organization	Wayne Community Health Centers Inc
Address	128 S 300 W
City	Bicknell
State	UT
ZIP	84715
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 26, 2006

Payer Source	Total Paid
Medicaid	$682.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	6,060	$70	$418.3K
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…	4,560	$40	$182.4K
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…	970	$50	$48.6K
D0220	Intraoral - periapical first radiographic image	270	$50	$14.2K
D0230	Intraoral - periapical each additional radiographic image	220	$40	$8.4K
D0120	Periodic oral evaluation - established patient	130	$50	$6K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	170	$10	$1.9K
D1120	Prophylaxis–child	160	$10	$1.3K
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.	100	$1	$390
D0272	N/A	10	$20	$240

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Wayne Community Health Centers Inc — 0 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	11	70	270	$110	$376.1K
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…	102	120	1,100	$30	$186.6K
D0120	Periodic oral evaluation - established patient	328	470	460	$80	$149.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	120	240	220	$50	$145.2K
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…	328	1,340	200	$80	$144K
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…	99	1,360	190	$70	$125K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	8	20	70	$50	$71K
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.	47	90	120	$40	$41.1K
D0220	Intraoral - periapical first radiographic image	267	440	470	$20	$32.8K
D1120	Prophylaxis–child	274	420	440	$20	$30.7K

Showing 1–10 of 19

Related Providers

Other providers that share a Tax Identification Number (TIN) with Wayne Community Health Centers Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cole Robinson	UT	Interventional Pain Medicine Physician	$232.4K	$0
Justin Archibald	UT	Medical Physician Assistant	$140.4K	$0
Daniel Smith	UT	Family Medicine Physician	$107.1K	$0
Justin Abbott	UT	Family Medicine Physician	$16.4K	$0

Wayne Community Health Centers Inc — Billing Profile & Reimbursement Data

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Wayne Community Health Centers Inc — 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

Frequently Asked Questions

References