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.

Neighborhood Healthcare (NPI 1154786846)

Field	Value
Entity Type	Organization
Organization	Neighborhood Healthcare
Address	1030 E Florida Ave
City	Hemet
State	CA
ZIP	92543
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 22, 2015

Payer Source	Total Paid
Medicaid	$160.1M
Medicare	$0

Key Findings

This provider is effectively single-payer in the Medicare/Medicaid mix: there is no Medicare billing on file while Medicaid revenue totals $160.1M, indicating that the organization’s financial footprint in public payers is almost entirely Medicaid-driven. The NPI was enumerated on 2015-12-22 (~11 years ago), so this Medicaid-dominant profile is the product of an established, multi-year presence in the market.

Revenue is extremely concentrated in a very small set of Medicaid codes: the precomputed top 3 Medicaid codes together account for 99.9% of this provider’s total Medicaid revenue. T1015 alone generates $146.6M (91.5% of Medicaid revenue), 00003 contributes $13M (8.1%), and 98941 contributes $337.9K (0.2%), so financial performance is driven almost entirely by the all-inclusive clinic-visit bundle and one high-volume ancillary code.

The code mix and dollar distribution strongly reflect FQHC-style operations: T1015 (Clinic visit/encounter, all-inclusive) dominates revenue and is consistent with bundled, per-visit payment for comprehensive encounters at federally qualified health centers. FQHC-specific codes such as G0467, G2025 and G0511 appear in the billing but generate only small amounts of revenue (e.g., G0467: 286 claims, $7.2K), suggesting that most clinical activity and reimbursement are captured under the T1015 bundle rather than by separate fee-for-service payments.

Although many common office E/M and procedure codes have very high claim volumes, their reported average paid amounts are $0, which indicates those encounters are likely being reported but reimbursed through the T1015/FQHC payment bundle or other non-fee-for-service mechanisms. Examples include 99213 with 197.2K claims and $0 avg paid/claim, 99212 with 41.7K claims and $0 avg paid/claim, and 99214 with 39.5K claims and $0 avg paid/claim; these high claim counts combined with $0 payments point to bundled reimbursement capture rather than separate Medicaid payments for each listed code.

On competitive standing, the provider is a statewide outlier for its primary revenue-driving codes: T1015 ranks #16 of 1550 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), marking the organization as a dominant Medicaid clinic-visit billing entity in California. Similarly, 98941 ranks #13 of 494 providers in-state (98th percentile; extreme outlier, far above typical state volume), indicating unusually high statewide volume for spinal manipulation services relative to peers.

Notwithstanding the revenue concentration, the provider shows breadth in service offerings that do not materially drive Medicaid revenue — behavioral health and alternative therapy activity is visible in claim counts even if payments are minimal. For example, 90832 (psychotherapy) has 31.7K claims and ranks #25 of 1431 providers in-state (98th percentile; extreme outlier for volume) and 97810 (acupuncture) has 4.6K claims and ranks #88 of 645 (86th percentile), which signals substantive service lines reported on claims that are not contributing directly to standalone Medicaid revenue.

Operationally, the presence of telehealth and care-management codes at low revenue levels suggests capacity in those areas but not a revenue focus: G2025 (telehealth) shows 270 claims and $3.8K revenue (rank #265 of 575, 54th percentile) and G0511 (general care management) shows 257 claims and $2.8K revenue (rank #94 of 183, 49th percentile). These are typical, unremarkable volumes for in-state peers and likely represent supplemental programs or bundled services rather than primary revenue drivers.

From a risk and planning perspective, the provider’s Medicaid dependence and extreme concentration in T1015 mean that changes to FQHC payment rules, bundle definitions, or visit-counts could materially impact overall revenue. Given the NPI tenure (~11 years) and the provider’s dominant rank for T1015, analysts should view this entity as an established Medicaid clinic operating at scale under FQHC payment constructs, with ancillary high-volume services (e.g., 98941) that distinguish it from many peers.

Medicaid: Complete Services Breakdown

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	479,060	$310	$146.6M
00003	N/A	32,260	$400	$13M
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	30,720	$10	$337.9K
98940	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.	15,090	$10	$135.8K
0012A	N/A	130	$70	$8.8K
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…	290	$30	$7.2K
0002A	N/A	90	$70	$6.1K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	270	$10	$3.8K
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	260	$10	$2.8K
0001A	N/A	20	$70	$1.2K

Showing 1–10 of 65

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

Neighborhood Healthcare — 2 of 13 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

65 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	16	1,550	38,050	$190	$14.1M
00003	N/A	188	690	14,940	$260	$7.7M
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…	740	1,030	1,050	$70	$219.7K
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…	239	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…	298	13,300	640	$40	$169.6K
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…	1,782	4,230	210	$110	$135K
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…	86	14,520	760	$10	$122.8K
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…	25	1,430	640	$30	$93.9K
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…	253	770	190	$130	$93.2K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	469	510	500	$10	$89.3K

Showing 1–10 of 65

Related Providers

Other providers that share a Tax Identification Number (TIN) with Neighborhood Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$125M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$46.7M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$38.3M
Neighborhood Healthcare	CA	Federally Qualified Health Center (FQHC)	$0	$33.1M

Nearby Providers

Other providers in the same ZIP code as Neighborhood Healthcare, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kpc Global Medical Centers, Inc.	CA	General Acute Care Hospital	$0	$29.4M
Hemet Valley Ambulance Service Inc	CA	Ambulance	$2.6M	$15.5M
Kishore Sehgal	CA	Hematology & Oncology Physician	$4.1M	$0
Evelyn Mendoza	CA	Specialist	$3.2M	$0
Stanley Schinke	CA	Specialist	$2.8M	$0
Gerard Carvalho	CA	Otolaryngology Physician	$133.8K	$764.8K
Kpc Biotech, Inc	CA	Clinical Medical Laboratory	$40.7K	$755.1K
Robert Harford	CA	Dermatology Physician	$550.7K	$7.6K
John Desnoyers	CA	Emergency Medicine Physician	$227.5K	$141.9K
James Tsai	CA	Hematology & Oncology Physician	$177.3K	$0

Neighborhood Healthcare — Billing Profile & Reimbursement Data

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Neighborhood Healthcare — 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