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.

Bay Area Community Health (NPI 1184791998)

Field	Value
Entity Type	Organization
Organization	Bay Area Community Health
Address	1999 Mowry Avenue Suite A&b&d&f&n
City	Fremont
State	CA
ZIP	94538
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 29, 2006

Payer Source	Total Paid
Medicaid	$164.6M
Medicare	$0

Key Findings

BAY AREA COMMUNITY HEALTH is effectively a Medicaid-centric provider: there is no Medicare billing on file and reported Medicaid revenue totals $164.6M. This makes the organization heavily dependent on Medicaid as its primary payer rather than having a balanced Medicare/Medicaid mix.

Revenue is extremely concentrated in a very small set of codes — the precomputed top 3 Medicaid codes by revenue account for 97.8% of this provider's total Medicaid revenue. The single largest contributor is T1015 with $84.9M (51.7% of Medicaid revenue) and the second is 00003 with $74.1M (45.1% of Medicaid revenue); the third is 99213 with $1.6M (1.0% of Medicaid revenue).

The top-revenue code mix implies an FQHC-style operating model built around bundled clinic encounters and high-volume encounter-based services: T1015 is a clinic visit/encounter (all-inclusive) and G0467 appears on the file as an FQHC visit code, while 00003 (no description available in the data) is an unusually large contributor. The dominance of T1015 and 00003 suggests day-to-day revenue is driven by routine, bundled ambulatory encounters rather than by high-reimbursement specialty procedures.

Several top codes show the provider is a statewide volume leader or outlier for those services. 00003 ranks #3 of 688 providers in-state and is flagged as an "extreme outlier, far above typical state volume," while T1015 ranks #53 of 1550 providers (97th percentile) and is described as "notably above typical state volume." Even 99213 ranks #46 of 14524 providers (100th percentile) and is labeled an "extreme outlier," which indicates unusually high claim counts for that E/M line despite its modest revenue contribution.

Operationally, utilization patterns show very high claim volumes for low average payment-per-claim lines: for example, 99213 has 263K claims at $6 avg paid/claim producing $1.6M revenue, and T1015 has 325.1K claims at $261 avg paid/claim producing $84.9M. This combination points to a high-throughput ambulatory clinic model where encounter volume is a primary driver of top-line Medicaid receipts rather than high per-claim reimbursement.

The provider offers a broad mix of primary care and wraparound services typical of FQHCs: behavioral health codes (90832 at 28.1K claims, ranked #28 of 1431, 98th percentile), immunizations (90651, 90715), well-patient visits across age groups (99396, 99395, 99394, 99393), and some ancillary services (92014 ophthalmology, 98940/98941 manipulation). These codes each contribute modest revenue but together illustrate multidisciplinary service lines beyond the two dominant encounter codes.

Competitive and contracting implications are clear: because two codes (T1015 and 00003) together represent the vast majority of Medicaid revenue and the provider ranks as an outlier in state volume for those codes, payers should treat BAY AREA COMMUNITY HEALTH as a major Medicaid encounter-volume partner in the region. Its outsized rank for 00003 (#3 of 688, extreme outlier) in particular marks it as a high-capacity site for whatever service that code represents, which is material for network adequacy and rate negotiations.

BAY AREA COMMUNITY HEALTH is a long-tenured provider: its NPI was enumerated on 2006-11-29 (~20 years ago). The combination of long tenure and concentrated, high-volume Medicaid billing suggests established operational workflows focused on high-throughput, bundled ambulatory encounters typical of Federally Qualified Health Centers.

Medicaid: Complete Services Breakdown

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

181 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	325,130	$260	$84.9M
00003	N/A	238,190	$310	$74.1M
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…	262,970	$10	$1.6M
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…	28,060	$20	$589.2K
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…	59,400	$10	$534.6K
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,…	56,840	$10	$397.9K
98940	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.	4,840	$80	$377.4K
G9012	Other specified case management service not elsewhere classified	2,620	$120	$316.7K
99203	The provider sees a new 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 provider…	8,550	$30	$265K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	22,700	$10	$227K

Showing 1–10 of 181

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

Bay Area Community Health — 9 of 25 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

181 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	53	1,550	38,050	$190	$14.1M
00003	N/A	3	690	14,940	$260	$7.7M
G9012	Other specified case management service not elsewhere classified	228	720	1,110	$110	$651.3K
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…	3,896	4,290	780	$140	$400.1K
G9008	Coordinated care fee, physician coordinated care oversight services	284	490	660	$70	$396.7K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	167	250	120	$850	$378K
S4993	Contraceptive pills for birth control	117	210	1,290	$110	$295.6K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	819	900	560	$70	$230.3K
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…	472	1,030	1,050	$70	$219.7K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	617	760	1,930	$20	$196K

Showing 1–10 of 181

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bay Area Community Health	CA	Federally Qualified Health Center (FQHC)	$0	$60M
Bay Area Community Health	CA	Federally Qualified Health Center (FQHC)	$0	$39M
Hoan Van	CA	Foot & Ankle Surgery Podiatrist	$229.9K	$24.8K
Enna Chen	CA	Family Nurse Practitioner	$107.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington Township Hospital District	CA	General Acute Care Hospital	$0	$28.1M
Fremont Ambulatory Surgery Center, LP	CA	Ambulatory Surgical Clinic/Center	$1.9M	$7.1M
Arbor Vita Corporation	CA	Clinical Medical Laboratory	$787.7K	$6.3M
Thuy Vo	CA	Family Nurse Practitioner	$4.4M	$0
Puneet Chandak	CA	Nuclear Medicine Physician	$3.1M	$0
Claude Burdick	CA	Anatomic Pathology & Clinical Pathology Physician	$2.7M	$0
Ashit Jain	CA	Cardiovascular Disease Physician	$2.1M	$0
Li-min Hu	CA	Pediatrics Physician	$2.1M	$0
Rajesh Suri	CA	Cardiovascular Disease Physician	$1.8M	$0
Washington Outpatient Surgery Center, LLC	CA	Ambulatory Surgical Clinic/Center	$1.1M	$660.9K

Bay Area Community Health — Billing Profile & Reimbursement Data

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Bay Area Community Health — 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