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

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

Group Health, Inc. (NPI 1194051151)

Group Health, Inc. is a multi-specialty clinic/center provider located in Andover, Minnesota. This profile covers 0 Medicare and 171 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	Group Health, Inc.
Address	15245 Bluebird St Nw
City	Andover
State	MN
ZIP	55304
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	October 27, 2009

Payer Source	Total Paid
Medicaid	$13M
Medicare	$0

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

171 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…	38,980	$70	$2.9M
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…	51,690	$50	$2.7M
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	27,600	$30	$800.5K
99392	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…	8,160	$70	$546.8K
X5622	N/A	11,310	$50	$520.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	16,470	$30	$444.8K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	12,380	$40	$433.3K
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…	6,930	$60	$401.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,230	$60	$398.6K
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…	3,160	$100	$306.2K

Showing 1–10 of 171

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Group Health, Inc. — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

171 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	134	210	560	$60	$822.1K
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…	45	1,180	1,150	$80	$605.7K
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.	55	100	510	$40	$560.8K
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…	39	1,200	1,030	$70	$549.7K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	33	80	1,070	$90	$341.2K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	12	20	110	$240	$253.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	10	20	220	$190	$189.2K
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…	52	420	230	$90	$186.2K
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	10	310	810	$30	$166.5K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	34	40	150	$320	$165.6K

Showing 1–10 of 171

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$204M
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Saint Joseph Mercy Livingston Hospital	MI	General Acute Care Hospital	$0	$18.3M
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$14.8M
Group Health, Inc.	MN	Clinical Medical Laboratory	$2.4M	$11.5M
Group Health, Inc.	MN	Pediatric Dentistry	$0	$5.6M
Polly Quiram	MN	Ophthalmology Physician	$3.7M	$0
Peter Kent	MN	Rheumatology Physician	$1.6M	$0
Edwin Ryan	MN	Ophthalmology Physician	$1.5M	$0
Elizabeth Miller	MN	Rheumatology Physician	$1.3M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Speech & Therapy Services, LLC	MN	Speech-Language Pathologist	$0	$12.7M
Milk Moms, Inc	MN	Durable Medical Equipment & Medical Supplies	$0	$10.8M
Tamara Smith	MN	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$10.5M
Accukare, Inc	MN	Home Health Agency	$0	$9.6M
Claire Saad	MN	Family Medicine Physician	$75K	$0
Paul Lysne	MN	Family Medicine Physician	$72.5K	$0
Joseph Wilkie	MN	Physician Assistant	$17.1K	$0
Jennifer Vlach	MN	Clinical Social Worker	$1.9K	$0

Group Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Group Health, Inc. — Billing Profile & Reimbursement Data policy alerts

Group Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Group Health, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References