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

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

Advocates For A Healthy Community Inc (NPI 1164657318)

Advocates For A Healthy Community Inc is a federally qualified health center (fqhc) provider located in Springfield, Missouri. This profile covers 0 Medicare and 146 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	Advocates For A Healthy Community Inc
Address	440 E Tampa St
City	Springfield
State	MO
ZIP	65806
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 18, 2009

Payer Source	Total Paid
Medicaid	$23.2M
Medicare	$0

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

146 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	96,510	$90	$8.9M
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…	58,960	$60	$3.5M
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…	16,470	$50	$790.7K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	5,530	$120	$674.9K
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…	7,920	$80	$625.4K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	5,800	$90	$516.1K
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…	6,720	$70	$484.1K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	5,510	$80	$441K
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.	16,630	$20	$399K
80055	The lab analyst performs an obstetric panel; this panel must include tests for a complete blood count with differential, a hepatitis B surface antigen, a rubella antibody, a qualitative non…	2,770	$140	$392.6K

Showing 1–10 of 146

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Advocates For A Healthy Community Inc — 18 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

146 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	41	240	1,740	$40	$353.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	42	320	980	$40	$352.7K
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	148	160	720	$60	$218.3K
0241U	N/A	29	80	330	$110	$192.3K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	45	260	390	$60	$188.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	38	130	450	$60	$158.5K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	109	120	260	$50	$136.3K
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…	5	3,170	230	$70	$128.1K
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…	78	200	510	$20	$120.4K
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…	16	4,310	300	$60	$110.8K

Showing 1–10 of 146

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lester E Cox Medical Centers	MO	General Practice Physician	$0	$9.2M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$4.9M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$3.8M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$3.6M
Ronald Pritchard	OK	Diagnostic Radiology Physician	$166.5K	$5K
Patrick Cabrera	MO	Diagnostic Radiology Physician	$94.5K	$11.7K
David Owens	GA	Diagnostic Radiology Physician	$86.3K	$230
Jose Padilla	MO	Surgery Physician	$34.6K	$0
Angela Limpus	MO	Nurse Practitioner	$31.8K	$2K
Louis Delcampo	MO	Anesthesiology Physician	$7.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
K And C Stepping Stones, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$54M
K And C Stepping Stones, LLC	MO	Personal Care Attendant	$0	$6.9M
Ashley Popejoy	MO	Pediatric Dentistry	$0	$5.3M
Great Circle	MO	Psychiatric Residential Treatment Facility	$0	$3.8M
Sarah Young	MO	Medical Physician Assistant	$101.6K	$0
Kia Washington	MO	Women's Health Nurse Practitioner	$130	$42.9K

Advocates For A Healthy Community Inc — Billing Profile & Reimbursement Data

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Advocates For A Healthy Community 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

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