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

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

Verge Primary Home Care (NPI 1124208368)

Field	Value
Entity Type	Organization
Organization	Verge Primary Home Care
Address	4622 S. Closner Blvd
City	Edinburg
State	TX
ZIP	78539
Taxonomy	Personal Care Attendant
NPI Enumerated	November 5, 2007

Payer Source	Total Paid
Medicaid	$42.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	721,310	$50	$39M
T1005	Respite care services, up to 15 minutes	41,590	$50	$2M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	63,510	$30	$1.7M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Verge Primary Home Care — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	76	1,680	50,290	$60	$9.5M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	250	1,050	23,280	$30	$1.8M
T1005	Respite care services, up to 15 minutes	47	560	8,490	$50	$842.3K

Nearby Providers

Other providers in the same ZIP code as Verge Primary Home Care, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mcallen Hospitals L P	TX	General Acute Care Hospital	$0	$124.6M
Doctors Hospital At Renaissance, Ltd	TX	General Acute Care Hospital	$0	$65.1M
Tropical Texas Behavioral Health	TX	Multi-Specialty Clinic/Center	$0	$61.5M
Nuestro Sagrado Corazon Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$56.5M
Regional Nursing Services Mgmt., Inc.	TX	Home Health Agency	$0	$45.5M
Arc Primary Care, LLC.	TX	Home Health Agency	$0	$42.3M
Heaven Sent Services, L.L.C.	TX	Personal Care Attendant	$0	$40.4M
Ddnj, Inc.	TX	In Home Supportive Care Agency	$0	$34.3M
Life Choices Unlimited, Inc.	TX	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$28M
Palm Valley Primary Home Care, Inc.	TX	Personal Care Attendant	$0	$27.6M

Verge Primary Home Care — Billing Profile & Reimbursement Data

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Verge Primary Home Care — Billing Profile & Reimbursement Data

Sign up for Verge Primary Home Care — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References