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NPI 1205308855 · Lander, WY · Federally Qualified Health Center (FQHC)
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Community Health Center Of Central Wyoming Inc is a federally qualified health center (fqhc) provider located in Lander, Wyoming. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Community Health Center Of Central Wyoming Inc |
| Address | 8185 Highway 789 |
| City | Lander |
| State | WY |
| ZIP | 82520 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | December 20, 2018 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $2.8M |
| Medicare | $0 |
Community Health Center of Central Wyoming Inc is effectively a single-payer Medicaid provider: there is no Medicare billing on file while its lifetime Medicaid revenue is $2.8M. This concentrated payer footprint indicates the organization operates primarily within Medicaid-serving networks rather than Medicare markets, consistent with its Federally Qualified Health Center taxonomy and community-focused mission.
Revenue is heavily concentrated in a single code: T1015 (Clinic visit/encounter, all-inclusive) accounts for $2.7M, representing 97.3% of the provider’s total Medicaid revenue. This concentration shows the center’s billing model centers on comprehensive clinic encounter payments rather than a broad mix of high-value procedure codes.
The top three Medicaid codes are almost the entirety of reported revenue: the precomputed top-3 accounts for 99.9% of total Medicaid revenue. That near-total concentration implies limited diversification of billable services in the Medicaid dataset and suggests operational reliance on high-volume, all-inclusive clinic encounter billing.
T1015 volume is substantial in absolute terms (9K claims) but its competitive standing statewide is modest: the provider ranks #11 of 53 in Wyoming (81st percentile) for T1015, described as typical, unremarkable volume. In other words, while T1015 dominates this provider’s revenue, the center is not a statewide outlier or dominant provider for that code.
Secondary codes are small contributors by revenue and reflect care coordination and occasional higher-acuity visits: S0281 (Medical home program) produced $68.7K (2.4% of Medicaid revenue) across 11.5K claims, indicating active care coordination billing consistent with FQHC patient management, while 99204 produced $4.5K (0.2%) across 30 claims, showing occasional new patient visits at higher complexity. Both codes rank near the middle of in-state peers (S0281 at 47th percentile among 18 providers; 99204 at 48th percentile among 30 providers), reinforcing a typical, non-dominant competitive profile for these services.
The provider’s service mix and code list (dominant use of T1015 plus high counts of preventive, vaccine, and point-of-care test codes such as 99394, 90460, 87880, and several COVID/respiratory test codes) align with a primary care, community health center operational model offering routine immunizations, well visits, and on-site rapid testing. Many of these ancillary codes show nonzero claim volumes but report $0 paid/claim in the dataset, indicating either bundled reimbursement under T1015 or state-specific payment policies that emphasize encounter-based payment for FQHCs.
Competitive positioning across many ancillary codes is typical rather than exceptional: multiple codes (for example 99214 at the 91st percentile for 3.3K claims, 99394 at the 93rd percentile for 334 claims, and 99213 at the 82nd percentile for 2.5K claims) show the provider participates at or above median volumes in several preventive and established visit categories but does not dominate statewide markets for these services. This pattern is consistent with a community health center that maintains steady primary care throughput without specialty service concentration.
The provider has been an enumerated NPI since 2018-12-20 (~8 years), indicating an established presence in the community but not a decades-long tenure. This tenure length is sufficient to have built stable Medicaid billing patterns focused on encounter-based revenue, as reflected in the large cumulative T1015 revenue share.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
20 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 9,040 | $300 | $2.7M |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | 11,450 | $10 | $68.7K |
| 99204 | The provider sees a new 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 provider… | 30 | $150 | $4.5K |
| 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… | 3,310 | $1 | $3.3K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 620 | $1 | $620 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 10 | $0 | $0 |
| 86328 | The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2… | 50 | $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. | 140 | $0 | $0 |
| 87807 | The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation. | 60 | $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. | 630 | $0 | $0 |
Showing 1–10 of 20
How this provider's Medicaid billing volume and revenue compare to other Wyoming providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Wyoming median
20 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 11 | 50 | 1,690 | $360 | $3.3M |
| S0281 | Medical home program, comprehensive care coordination and planning, maintenance of plan | 10 | 20 | 13,160 | $10 | $190.1K |
| 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… | 22 | 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… | 48 | 260 | 420 | $30 | $67.2K |
| 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. | 31 | 70 | 490 | $40 | $42.9K |
| 99204 | The provider sees a new 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 provider… | 16 | 30 | 30 | $110 | $35.2K |
| 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… | 39 | 40 | 170 | $70 | $34.1K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 10 | 30 | 100 | $60 | $17.8K |
| 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,… | 33 | 70 | 70 | $20 | $10.2K |
| 87428 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2… | 3 | 10 | 90 | $30 | $8.9K |
Showing 1–10 of 20
Other providers in the same ZIP code as Community Health Center Of Central Wyoming Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Riverton Memorial Hospital LLC | WY | Rural Acute Care Hospital | $0 | $4.7M |
| Frontier Wyoming, L.L.C. | WY | Home Health Agency | $0 | $2.5M |
| Lander Medical Clinic, PC | WY | Family Medicine Physician | $0 | $2.1M |
| Eh Health Home Health Of The Northwest, LLC | WY | Home Health Agency | $0 | $2M |
| Gregory P Clifford Md PC | WY | Personal Emergency Response Attendant | $0 | $1.8M |
| Guardian Flight LLC | WY | Air Ambulance | $699K | $586.5K |
| Jessica West | WY | Case Manager/Care Coordinator | $0 | $964.6K |
| Knell Access Management | WY | In Home Supportive Care Agency | $0 | $893.6K |
| Wyoming Path Behavioral Health, LLC | WY | Community/Behavioral Health Agency | $0 | $836.8K |
| Fremont County Pediatric Clinic | WY | Pediatrics Physician | $0 | $629.4K |
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