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

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

Five Rivers Health Centers (NPI 1114280690)

Five Rivers Health Centers is a federally qualified health center (fqhc) provider located in Dayton, Ohio. This profile covers 0 Medicare and 114 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Five Rivers Health Centers
Address	2261 Philadelphia Dr
City	Dayton
State	OH
ZIP	45406
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 20, 2012

Payer Source	Total Paid
Medicaid	$13.1M
Medicare	$0

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

114 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	100,980	$100	$9.6M
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…	113,990	$20	$2.4M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	45,160	$10	$361.2K
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…	7,190	$20	$143.9K
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…	3,460	$30	$114.2K
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,…	7,070	$10	$98.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,560	$30	$64K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,900	$30	$49.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	6,820	$10	$34.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,340	$10	$30K

Showing 1–10 of 114

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Five Rivers Health Centers — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

114 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	24	530	7,190	$70	$1.5M
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…	993	4,510	500	$60	$377.8K
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…	49	5,080	560	$40	$323.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	118	430	560	$60	$303.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	149	480	450	$70	$292.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	179	480	280	$70	$181.7K
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.	409	700	210	$60	$154.1K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	58	290	180	$50	$147.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	714	920	510	$70	$144K
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…	148	1,320	450	$40	$139.1K

Showing 1–10 of 114

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Five Rivers Health Centers	OH	Federally Qualified Health Center (FQHC)	$0	$7.9M
Mark Marinella	OH	Medical Oncology Physician	$1.1M	$0
Mark Romer	OH	Hematology & Oncology Physician	$945.4K	$0
Charles Bane	OH	Hematology & Oncology Physician	$749.1K	$0
Burhan Yanes	OH	Hematology & Oncology Physician	$747.7K	$0
Roger Wood	OH	Hematology & Oncology Physician	$548K	$0
Ketan Shah	OH	Hematology & Oncology Physician	$521.8K	$0
Shamim Jilani	OH	Medical Oncology Physician	$511.3K	$0
Jawad Jilani	NV	Gastroenterology Physician	$152.5K	$40.4K
Jennifer Wu	OH	Surgery Physician	$139.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Senior Resource Connection	OH	In Home Supportive Care Agency	$0	$8.1M
Rose Health Care Services, Ltd	OH	Home Health Agency	$0	$6.8M
Bharat Raju	OH	Family Medicine Physician	$59.6K	$433.8K
Kurt Stedje	OH	Diagnostic Radiology Physician	$98.9K	$0
Adrienne Merrick	OH	Certified Registered Nurse Anesthetist	$56.3K	$0
Ejaz Ahmad	OH	Anatomic Pathology & Clinical Pathology Physician	$43.5K	$0
Martin Schear	OH	Family Medicine Physician	$26.3K	$0
Adam Waldman	OH	Anesthesiology Physician	$8.9K	$0

Five Rivers Health Centers — Billing Profile & Reimbursement Data

Sign up for Five Rivers Health Centers — Billing Profile & Reimbursement Data policy alerts

Five Rivers Health Centers — Billing Profile & Reimbursement Data

Sign up for Five Rivers Health Centers — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References