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.

Fairfax County, Virginia (NPI 1174558266)

Field	Value
Entity Type	Organization
Organization	Fairfax County, Virginia
Address	12011 Government Center Pkwy
City	Fairfax
State	VA
ZIP	22035
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$55.7M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-only billing operation: there is no Medicare billing on file while total Medicaid revenue is $55.7M, indicating the provider’s financial footprint is concentrated entirely in state Medicaid programs rather than in fee-for-service Medicare. The absence of any Medicare CPT/HCPCS activity suggests its services are primarily designed for populations and programs reimbursed by Medicaid.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes account for 99.9% of the provider’s total Medicaid revenue, with T1017 generating $31.3M (56.2%), H2022 $16.8M (30.2%), and T2023 $7.5M (13.5%). This tight code mix implies that a very small set of service lines drives virtually all of the organization’s Medicaid income.

The service mix implied by the dominant codes points to a community-based care coordination and behavioral health support model: T1017 (Targeted case management, each 15 minutes), T2023 (Targeted case management; per month), and H2022 (Community-based wrap-around services, per diem) are all care-management and wrap-around service codes, indicating operations focused on case management, service planning, and ongoing community service delivery rather than acute clinical or procedure-driven care. The presence of both time-based (T1017) and monthly (T2023) targeted case management suggests a program that bills at both encounter-level and episodic/monthly rates.

Competitive standing within Virginia is strong on the provider’s core codes. The provider ranks #2 of 46 in the state for T1017 (98th percentile, notably above typical state volume), ranks #12 of 136 for H2022 (92th percentile, notably above typical state volume), and is the statewide leader for T2023 (rank #1 of 40, 100th percentile; labeled an extreme outlier), which together indicate the organization is a major regional provider of targeted case management and wrap-around services.

Program-level risk is concentrated: because almost all Medicaid revenue comes from three behavioral health/case-management codes, the provider’s reimbursement and operational stability are highly dependent on continued Medicaid policy, coding guidance, and authorization patterns for these specific service lines. Any changes to coverage, per-claim rates, or utilization controls for T1017, H2022, or T2023 would disproportionately affect total revenue given their combined 99.9% share.

Operational scale and utilization signal high volume in recurring community services: the claim counts reported for the top codes (90.7K claims for T1017 and 53.7K claims for H2022) indicate substantial ongoing service delivery and patient touchpoints rather than isolated or episodic care. The combination of high claim counts and per-claim payments (e.g., $345 avg paid/claim for T1017 and $313 avg paid/claim for H2022) underscores a high-throughput, per-encounter/bundle service model.

Minor codes represent negligible revenue and do not materially diversify the business mix: T2024 contributed $31.8K (0.1%), T1999 $23.6K (0.0%), and 96372 $1.2K (0.0%) of Medicaid revenue, which confirms that ancillary procedures and one-off supplies are not significant revenue sources for this provider. These small streams are unlikely to offset concentration risk tied to the top three codes.

The provider has a long tenure in the national registry, with NPI enumeration on 2006-07-11 (~20 years ago), suggesting institutional stability and a sustained operating presence in the market; coupled with the demonstrated high statewide ranks on core codes, this tenure is consistent with an established community-based service provider rather than a new entrant.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1017	Targeted case management, each 15 minutes	90,660	$350	$31.3M
H2022	Community-based wrap-around services, per diem	53,730	$310	$16.8M
T2023	Targeted case management; per month	24,470	$310	$7.5M
T2024	Service assessment/plan of care development, waiver	90	$340	$31.8K
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	20	$1,570	$23.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	130	$10	$1.2K

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

Fairfax County, Virginia — 3 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2022	Community-based wrap-around services, per diem	12	140	4,450	$1,150	$15.3M
T1017	Targeted case management, each 15 minutes	2	50	23,860	$330	$9.4M
T2023	Targeted case management; per month	1	40	3,000	$300	$1.3M
T1999	Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks"	3	10	20	$1,310	$98.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	328	510	340	$10	$15K
T2024	Service assessment/plan of care development, waiver	1	10	30	$330	$12.2K

Nearby Providers

Other providers in the same ZIP code as Fairfax County, Virginia, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fairfax County, Virginia	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$67.6M
Director Of Finance-county Of Fairfax Va	VA	Ambulance	$7.9M	$7.3M

Fairfax County, Virginia — Billing Profile & Reimbursement Data

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Fairfax County, Virginia — 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

Nearby Providers

Frequently Asked Questions

References