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

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

16th Street Community Health Center Inc. (NPI 1144593815)

Field	Value
Entity Type	Organization
Organization	16th Street Community Health Center Inc.
Address	309 E North St
City	Waukesha
State	WI
ZIP	53188
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	February 10, 2012

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	4,360	$150	$641.1K
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…	13,010	$30	$403.4K
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…	7,640	$30	$236.9K
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…	3,490	$20	$73.4K
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…	1,820	$20	$40.1K
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…	1,370	$30	$35.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	2,260	$10	$18.1K
Q3014	Telehealth originating site facility fee	1,210	$10	$15.7K
99442	N/A	1,340	$10	$14.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	280	$50	$14.1K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

16th Street Community Health Center Inc. — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	32	60	4,880	$230	$4.9M
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…	100	1,630	270	$40	$205.3K
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…	311	1,760	250	$40	$173.2K
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.	214	350	300	$50	$157.9K
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…	627	900	410	$70	$130.4K
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…	77	790	400	$40	$109.6K
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…	223	350	210	$60	$95.8K
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,…	354	690	160	$60	$90.4K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	42	110	270	$50	$87.4K
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	40	1,560	$20	$45.1K

Showing 1–10 of 39

Related Providers

Other providers that share a Tax Identification Number (TIN) with 16th Street Community Health Center Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
16th Street Community Health Center Inc.	WI	Federally Qualified Health Center (FQHC)	$0	$16.3M
Sixteenth Street Community Health Centers, Inc.	WI	Federally Qualified Health Center (FQHC)	$0	$13.8M
Sixteenth Street Community Health Centers, Inc.	WI	Federally Qualified Health Center (FQHC)	$0	$3.9M
Jon Englund	WI	Sports Medicine (Family Medicine) Physician	$69.9K	$0
George Morris	WI	Epilepsy Physician	$28.7K	$0
Christopher Weber	WI	Internal Medicine Physician	$9K	$0

Nearby Providers

Other providers in the same ZIP code as 16th Street Community Health Center Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prohealth Waukesha Memorial Hospital, Inc.	WI	General Acute Care Hospital	$0	$21.5M
Waukesha County	WI	Case Management Agency	$0	$18M
Waukesha County	WI	Community/Behavioral Health Agency	$0	$15M
Hometown Hospice & Homecare Inc	WI	Community Based Hospice Care Agency	$0	$12.1M
Prohealth Medical Group Inc.	WI	Pediatrics Physician	$0	$8.2M
Neurotech, LLC	WI	Physiological Laboratory	$145.8K	$7.8M
Commonheart, Inc.	WI	Community Based Hospice Care Agency	$0	$7.2M
Kinex Medical Company LLC	WI	Durable Medical Equipment & Medical Supplies	$0	$7.1M
Waukesha County	WI	Community/Behavioral Health Agency	$0	$3.2M
Oxygen One, Inc.	WI	Oxygen Equipment & Supplies (DME)	$0	$2.8M

16th Street Community Health Center Inc. — Billing Profile & Reimbursement Data

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16th Street Community Health Center Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References