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

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

Community Hospital (NPI 1174059786)

Field	Value
Entity Type	Organization
Organization	Community Hospital
Address	625 Albany Ave
City	Torrington
State	WY
ZIP	82240
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	May 3, 2017

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused clinic: there is no Medicare billing on file and all documented revenue is Medicaid-only, totaling $3.6M. The NPI was enumerated 2017-05-03 (~9 years ago), indicating roughly nine years of recorded activity under the current registration.

Revenue is highly concentrated in a single encounter code: T1015 (Clinic visit/encounter, all-inclusive) accounts for $3.6M and 99.7% of this provider's Medicaid revenue, and the precomputed top-3 codes account for 100.0% of total Medicaid revenue. That concentration implies the facility’s financial performance is driven almost entirely by bundled clinic encounters rather than a diversified mix of billable procedures.

Service-line profile aligns with a Rural Health Clinic/Center that bills primarily by all-inclusive clinic encounters: the dominance of T1015 (Clinic visit/encounter, all-inclusive) suggests operations are organized around bundled outpatient visits and encounter-based billing rather than fee-for-service procedural throughput. This matches the provider taxonomy (Rural Health Clinic/Center) and is consistent with a low-complexity outpatient-focused practice model.

Competitive standing for the top Medicaid code is solid but not dominant: T1015 ranks #5 of 53 providers in-state (92th percentile) and is described in the source as "typical, unremarkable volume for this code," indicating the clinic is a higher-volume state participant on that encounter code but still within the expected peer distribution. Secondary codes such as 99214 (5K claims, $2 avg paid/claim, $10K revenue) rank #11 of 223 in-state (95th percentile) yet account for only 0.3% of Medicaid revenue, reinforcing that high claim counts for certain E/M codes do not materially move total revenue.

Several commonly used CPT/HCPCS entries show nonzero claim counts but $0 avg paid/claim and $0 revenue (for example 99213: 6.4K claims, $0 avg paid/claim, $0 revenue; 87880: 932 claims, $0 avg paid/claim, $0 revenue). This pattern suggests many services are either bundled into the all-inclusive encounter reimbursement or are recorded for clinical tracking but not separately reimbursed by Medicaid for this provider.

Smaller-volume Medicaid codes reflect routine outpatient and preventive activity but contribute negligible revenue: examples include 99309 (111 claims, $17 avg paid/claim, $1.9K revenue) which ranks #8 of 17 in-state (56th percentile) and several preventive or screening codes (99391, 99394, 96110) with low claim counts and $0 reported revenue. The data indicate standard primary-care and nursing-facility follow-up services are present but are not revenue drivers.

The combination of a single dominant revenue code and many low-or-zero-paid ancillary codes creates revenue concentration risk: because T1015 drives 99.7% of Medicaid dollars and the top three codes equal 100.0% of Medicaid revenue, any Medicaid policy change, rate adjustment, or contract repricing for encounter-based payments could disproportionately affect the clinic’s financial stability. Analysts should treat Medicaid encounters reimbursement policy as the primary lever for financial forecasting.

Operationally, the clinic appears to capture respectable encounter volume within the state — e.g., T1015 at the 92th percentile and 99214 at the 95th percentile — yet its overall footprint remains modest in absolute revenue terms ($3.6M Medicaid, no Medicare). In short, COMMUNITY HOSPITAL functions as a stable, Medicaid-centered rural clinic with concentrated encounter-based billing and limited separate fee-for-service revenue streams.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	19,070	$190	$3.6M
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…	5,020	$1	$10K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	110	$20	$1.9K
1111F	No Summary found for this code	1,000	$0	$0
3074F	No Summary found for this code	80	$0	$0
3078F	No Summary found for this code	50	$0	$0
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	10	$0	$0
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	30	$0	$0
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	930	$0	$0
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	30	$0	$0

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Community Hospital — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	5	50	1,690	$360	$3.3M
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…	11	220	400	$50	$79.3K
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…	19	260	420	$30	$67.2K
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…	44	50	280	$70	$43.2K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	19	30	260	$20	$15.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	8	20	90	$20	$10.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	25	30	70	$60	$7.6K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	7	50	230	$10	$5.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	38	50	100	$10	$5.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	33	40	80	$10	$3.6K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omid Dilmaghanian	AZ	Family Medicine Physician	$341.1K	$0
Matthew Rutman	NY	Urology Physician	$277.1K	$39.9K
Kumari Usha	WI	Nephrology Physician	$258.2K	$0
Community Hospital	WY	Critical Access Hospital	$0	$240.2K
Shane Rowan	CO	Clinical Cardiac Electrophysiology Physician	$186.5K	$0
Jason Rytlewski	MO	Clinical Cardiac Electrophysiology Physician	$162.6K	$0
Cecilia Hirsch	CO	Cardiovascular Disease Physician	$133.9K	$0
David Bicknell	CO	Clinical Cardiac Electrophysiology Physician	$128K	$0
Lin-wang Dong	CO	Cardiovascular Disease Physician	$125.9K	$0
Nancy Bergquist	WY	Family Medicine Physician	$82.5K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Diversified Services Inc.	WY	Developmentally Disabled Services Day Training Agency	$0	$10M
Stacey Houk Family Enrichment Center LLC	WY	Professional Counselor	$0	$1.1M
New Hope Counseling	WY	Mental Health Counselor	$0	$900.7K
Memorial Hospital Of Laramie County	WY	Home Health Agency	$0	$743.2K
Healing Connections Mental Health	WY	Professional Counselor	$0	$580.1K
Frederick Voltmer	WY	Case Manager/Care Coordinator	$0	$465.1K
Amanda Barnes	WY	Case Manager/Care Coordinator	$0	$434.4K
Volunteers Of America Northern Rockies	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$367.7K
Number 34	WY	Case Management Agency	$0	$301.1K
Cowboy Clinic And Urgent Care LLC	WY	Family Nurse Practitioner	$0	$287.6K

Community Hospital — Billing Profile & Reimbursement Data

Sign up for Community Hospital — Billing Profile & Reimbursement Data policy alerts

Community Hospital — Billing Profile & Reimbursement Data

Sign up for Community Hospital — Billing Profile & Reimbursement Data policy alerts

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