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.

Spero Health Of Virginia, LLC (NPI 1104465103)

Field	Value
Entity Type	Organization
Organization	Spero Health Of Virginia, LLC
Address	314 Fairy Street Ext
City	Martinsville
State	VA
ZIP	24112
Taxonomy	Addiction Medicine (Family Medicine) Physician
NPI Enumerated	December 23, 2019

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9012	Other specified case management service not elsewhere classified	16,380	$230	$3.8M
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…	19,950	$60	$1.2M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	7,400	$150	$1.1M
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…	12,240	$80	$1M
H0005	Alcohol and/or drug services; group counseling by a clinician	23,000	$30	$620.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	13,050	$50	$587K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	9,750	$60	$555.5K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	5,280	$70	$390.9K
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,…	7,510	$30	$255.3K
H0014	Alcohol and/or drug services; ambulatory detoxification	1,650	$120	$205K

Showing 1–10 of 14

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

Spero Health Of Virginia, LLC — 3 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9012	Other specified case management service not elsewhere classified	18	120	2,160	$220	$1.6M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3	20	1,220	$110	$459.9K
H0004	Behavioral health counseling and therapy, per 15 minutes	34	100	3,280	$40	$455.8K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	42	170	3,790	$40	$415.2K
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…	208	3,520	370	$70	$280.7K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	21	100	2,220	$40	$214.2K
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…	164	4,010	290	$50	$199.8K
H0014	Alcohol and/or drug services; ambulatory detoxification	8	50	410	$130	$117.7K
90832	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…	196	330	270	$40	$112.2K
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…	224	610	150	$90	$104K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Spero Health Of Virginia, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Piedmont Regional Community Services Board	VA	Community/Behavioral Health Agency	$0	$93.9M
New Heights Community Support, LLC	VA	Community/Behavioral Health Agency	$0	$24M
Danville Regional Medical Center LLC	VA	General Acute Care Hospital	$0	$21M
Resilient Health And Community Support Services, LLC	VA	Community/Behavioral Health Agency	$0	$17.8M
Life Stages Inc.	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16M
Trinity Support Services	VA	Community/Behavioral Health Agency	$0	$13.6M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$10.1M
Acme Therapies Co	VA	Speech-Language Pathologist	$0	$9.1M
A Nurse's Touch	VA	In Home Supportive Care Agency	$0	$8.1M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$7.2M

Spero Health Of Virginia, LLC — Billing Profile & Reimbursement Data

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Spero Health Of Virginia, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References