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.

Portsmouth Community Health Center, Inc. (NPI 1134199193)

Field	Value
Entity Type	Organization
Organization	Portsmouth Community Health Center, Inc.
Address	1541 High St
City	Portsmouth
State	VA
ZIP	23704
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 24, 2006

Payer Source	Total Paid
Medicaid	$6.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

112 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	46,730	$50	$2.4M
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…	22,280	$70	$1.6M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	12,480	$40	$536.5K
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,…	7,110	$40	$248.8K
D0330	N/A	4,140	$40	$148.9K
99203	The provider sees a new 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 provider…	1,920	$70	$140.2K
D0150	Comprehensive oral evaluation – new or established patient	5,820	$20	$133.7K
D0140	Limited oral evaluation – problem focused	6,060	$20	$96.9K
D0230	Intraoral - periapical each additional radiographic image	15,830	$10	$95K
99204	The provider sees a new 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 provider…	880	$110	$93.5K

Showing 1–10 of 112

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

Portsmouth Community Health Center, Inc. — 13 of 25 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

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	107	3,520	370	$70	$280.7K
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…	658	1,340	710	$90	$245K
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…	51	4,010	290	$50	$199.8K
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…	196	650	150	$80	$115.4K
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…	90	330	270	$40	$112.2K
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…	267	660	310	$60	$110.9K
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…	317	580	150	$70	$109K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	187	230	120	$120	$108.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	226	230	5,240	$1	$93.2K
D2392	Post 2 surface resin‑based composite	589	690	280	$70	$88.1K

Showing 1–10 of 112

Nearby Providers

Other providers in the same ZIP code as Portsmouth Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brilliant Healthcare, Inc.	VA	Home Health Agency	$0	$19.1M
Hansel Union Consulting, PLLC	VA	Community/Behavioral Health Agency	$0	$19M
Lucas Lodge, LLC	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17M
City Of Portsmouth	VA	Community/Behavioral Health Agency	$0	$14.6M
Abs Lincs Va	VA	Clinical Psychologist	$0	$6.5M
James Bentley Treatment Program	VA	In Home Supportive Care Agency	$0	$6M
City Of Portsmouth	VA	Paramedic	$750.7K	$3.7M
Magdy Sidhom	VA	Anesthesiology Physician	$37.2K	$0

Portsmouth Community Health Center, Inc. — Billing Profile & Reimbursement Data

Sign up for Portsmouth Community Health Center, Inc. — Billing Profile & Reimbursement Data policy alerts

Portsmouth Community Health Center, Inc. — Billing Profile & Reimbursement Data

Sign up for Portsmouth Community Health Center, Inc. — 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