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

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

Chapa-de Indian Health Program, Inc. (NPI 1114057163)

Key Findings

Field	Value
Entity Type	Organization
Organization	Chapa-de Indian Health Program, Inc.
Address	11670 Atwood Rd
City	Auburn
State	CA
ZIP	95603
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$129.6M
Medicare	$0

CHAPA-DE INDIAN HEALTH PROGRAM, INC. reports $129.6M in lifetime Medicaid revenue and has no Medicare billing on file, making its operations effectively single-payer (Medicaid) in the available claims data. The absence of Medicare billing highlights that analysts should focus on Medicaid patterns when assessing payer risk and contracting exposure for this organization.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes (T1015, 00003, and G0467) account for 95.3% of the provider’s total Medicaid revenue. This concentration indicates financial dependence on a narrow service mix and suggests that changes to reimbursement or utilization for these codes would have outsized impact on the organization’s revenue.

T1015 is the largest single revenue driver with 125.9K claims, a $540 avg paid/claim and $68M in revenue (52.5% of Medicaid revenue). This heavy reliance on T1015 (clinic visit/encounter, all-inclusive) is consistent with an FQHC model delivering a large volume of bundled clinic visits, and the provider’s rank (#284 of 1550, 82nd percentile) suggests it operates at typical in-state volume for this service rather than dominating the state market.

00003 is the second-largest source with 89.6K claims, $528 avg paid/claim and $47.3M in revenue (36.5% of Medicaid revenue), and it ranks #34 of 688 providers in-state (95th percentile). That high percentile placement indicates the provider is among the higher-volume statewide performers for whatever service 00003 represents, making it a material competitive strength within its peer set.

G0467 (FQHC visit, established patient) contributes $8.1M (6.2% of Medicaid revenue) on 26.3K claims with a $307 avg paid/claim and ranks #16 of 1029 providers in-state (99th percentile). This code is described in the source as an "extreme outlier, far above typical state volume," so the provider is a clear statewide outlier and likely a major destination for established FQHC visits relative to peers.

Behavioral health-coded activity is notable: G0470 (FQHC mental health, established patient) shows 5.6K claims, $303 avg paid/claim and $1.7M revenue, ranking #2 of 157 providers in-state (99th percentile, "notably above typical state volume"). Combined with psychotherapy codes (90832, 90834, 90837) present in the top-25 list, the profile indicates a meaningful integrated mental-health service line inside the FQHC model.

Volume metrics show a high-count, low-unit-payment pattern on some E/M codes: 99213 appears with 79.5K claims at a $25 avg paid/claim yielding $2M (1.5% of Medicaid revenue), while 99212 and 99214 also have large claim volumes but small contributions to revenue. This mix suggests many brief, lower-reimbursed outpatient encounters are part of the center’s throughput, consistent with primary care and routine follow-up activity typical of FQHC operations.

The NPI tenure shows the provider was enumerated on 2007-03-07 (~19 years ago), indicating an established presence in the market. For competitive and contracting analysis, combine this longevity with the provider’s demonstrated statewide dominance on G0467 and high placement on 00003 to assess negotiating leverage for FQHC visit bundles and mental-health services within California Medicaid networks.

Medicaid: Complete Services Breakdown

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	125,930	$540	$68M
00003	N/A	89,600	$530	$47.3M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	26,260	$310	$8.1M
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…	79,510	$30	$2M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	5,650	$300	$1.7M
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…	1,290	$360	$462.2K
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.	1,170	$390	$458.2K
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,…	25,750	$20	$437.8K
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…	11,920	$20	$286.2K
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…	10,210	$20	$214.4K

Showing 1–10 of 93

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Chapa-de Indian Health Program, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

93 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	284	1,550	38,050	$190	$14.1M
00003	N/A	34	690	14,940	$260	$7.7M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,052	4,290	780	$140	$400.1K
0561	N/A	9	20	380	$170	$245.6K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	16	1,030	1,050	$70	$219.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,159	2,110	1,330	$30	$200.7K
90834	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…	421	1,950	500	$80	$179K
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…	1,110	13,300	640	$40	$169.6K
J3490	Unclassified drugs	1,170	1,390	670	$20	$159.5K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	2	160	190	$180	$141.3K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Placer County Hhs	CA	Community/Behavioral Health Agency	$0	$87.7M
County Of Placer	CA	Community/Behavioral Health Agency	$0	$28M
Matthew Janiga	CA	Urology Physician	$543.3K	$0
Ronald Smith	CA	Physical Therapist	$376K	$0
Ivan Anderson	CA	Cardiovascular Disease Physician	$353.9K	$140
Kristin Kaminski	CA	Clinical Psychologist	$223.4K	$0
David Spangler	CA	Clinical Neuropsychologist	$26.5K	$0

Chapa-de Indian Health Program, Inc. — Billing Profile & Reimbursement Data

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Chapa-de Indian Health Program, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References