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

Why is the Medicaid comparison limited to Illinois 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. Illinois (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 Health Improvement Center (NPI 1194794917)

Field	Value
Entity Type	Organization
Organization	Community Health Improvement Center
Address	320 E Central Ave
City	Decatur
State	IL
ZIP	62521
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 15, 2006

Payer Source	Total Paid
Medicaid	$34M
Medicare	$0

Key Findings

This provider is effectively single-payer in scope: Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $34M, indicating the organization’s operations and reimbursement are overwhelmingly driven by Medicaid. The NPI was enumerated 2006-03-15 (~20 years ago), which supports that this is an established FQHC with a long-running Medicaid-facing patient base.

Revenue is highly concentrated in a single billing line: the top 3 Medicaid codes account for 99.5% of this provider's total Medicaid revenue. In particular, T1015 alone drives the bulk of receipts with $33.6M revenue (98.9% of the provider’s Medicaid revenue) from 240.1K claims at an average paid/claim of $140.

The code mix and volumes point to an FQHC operating a high-volume, visit-based primary care and preventive services workflow: T1015 (Clinic visit/encounter, all-inclusive) dominance plus large counts of well-patient and screening codes (for example 99391 with 12.7K claims, 96110 with 12.7K claims, 99392 with 12.6K claims) indicate routine preventive visits and developmental screening are central to day-to-day operations. High counts of pediatric vaccine codes (e.g., 90670 9.7K claims, 90723 8.1K claims, 90680 7.1K claims) further support a strong immunization program and significant pediatric patient volume.

Despite extremely large claim counts for some E/M and preventive codes, per-claim payments for many of those codes are small, so claim volume does not translate proportionally into revenue outside the T1015 bundle. For example, 99213 appears with 111.8K claims but a $1 avg paid/claim for $111.8K revenue (0.3% of Medicaid revenue), and several well-visit and screening codes show $1 avg paid/claim with modest dollar contributions relative to the T1015 total. This suggests the clinic relies on the higher per-claim reimbursement of the all-inclusive T1015 encounter to generate most revenue while other high-volume activities are low-dollar on a per-claim basis.

Competitive standing within the state is strong for clinic-visit and preventive service lines: T1015 ranks #18 of 846 providers in-state (98th percentile; notably above typical state volume for this code), marking the organization as one of the larger in-state providers for bundled clinic encounters. Several other codes are at or near the top of in-state distributions—99213 ranks #16 of 14191 providers in-state (100th percentile; extreme outlier) and many vaccine and well-visit CPTs are in the 99th percentile—indicating the provider is a major throughput center for these services statewide.

The provider offers some behavioral health capacity but it represents a small share of Medicaid revenue: T1040 (Medicaid certified community behavioral health clinic services, per diem) shows 1K claims with $81 avg paid/claim and $83.2K revenue (0.2% of Medicaid revenue), and psychotherapy codes such as 90837 and 90834 are present at typical or modest volumes. This pattern points to behavioral health as an available but not revenue-driving service line compared with the dominant primary care/visit bundle.

The profile of extreme percentile placements across many pediatric, preventive, and vaccine codes (multiple codes listed at the 99th or 98th percentile and labeled as “extreme outlier” or “notably above typical state volume”) signals unusually high throughput for immunization and well-child/adolescent services. For payers and network planners, this combination—very high visit and vaccine volumes concentrated into the T1015 bundle—identifies the site as a high-capacity Medicaid primary-care and preventative immunization hub within the state market.

Medicaid: Complete Services Breakdown

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

78 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	240,070	$140	$33.6M
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…	111,840	$1	$111.8K
T1040	Medicaid certified community behavioral health clinic services, per diem	1,030	$80	$83.2K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	9,690	$1	$19.4K
90723	The provider administers a combination inactivated vaccine intramuscularly to prevent multiple diseases, including diphtheria, tetanus, acellular pertussis, hepatitis B, and polio.	8,080	$1	$16.2K
90680	This code represents a live pentavalent rotavirus vaccine given by mouth in a three–dose schedule to protect against rotavirus infection.	7,140	$1	$14.3K
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…	12,740	$1	$12.7K
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…	12,720	$1	$12.7K
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…	12,640	$1	$12.6K
0502F	No Summary found for this code	11,810	$1	$11.8K

Showing 1–10 of 78

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Community Health Improvement Center — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

78 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	18	850	7,490	$120	$3.9M
T1040	Medicaid certified community behavioral health clinic services, per diem	84	190	880	$70	$128.2K
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…	371	1,180	370	$90	$109.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	406	760	140	$110	$67.3K
96164	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of the patients’ physical health…	372	380	2,820	$10	$64.5K
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…	257	960	330	$30	$51K
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…	18	14,680	300	$50	$48.7K
0502F	No Summary found for this code	32	1,170	550	$30	$48.2K
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…	13	1,380	370	$40	$46.2K
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…	11	1,270	370	$40	$40.8K

Showing 1–10 of 78

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Marys Hospital Sisters Of The Third Order Of St Francis	IL	Ambulance	$0	$7M
James Bock	IL	Family Medicine Physician	$674.4K	$770K
Manohar Kola	IL	Cardiovascular Disease Physician	$401.1K	$135.5K
Danxuan Long	IL	Pulmonary Disease Physician	$314.5K	$114.9K
Luis Caceres	IL	Cardiovascular Disease Physician	$326.5K	$93.7K
Manjeshwar Prabhu	IL	Pulmonary Disease Physician	$207.4K	$151.7K
Rana Mahmood	IL	Neurology Physician	$160.8K	$184.5K
Amit Dande	IL	Interventional Cardiology Physician	$235.5K	$106.2K
Patrick Murphy	IL	Interventional Cardiology Physician	$201.3K	$69.1K
Theodore Addai	IL	Cardiovascular Disease Physician	$195.8K	$67.9K

Community Health Improvement Center — Billing Profile & Reimbursement Data

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Community Health Improvement Center — 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