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

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

Northumberland County Mental Health Mental Retardation Program (NPI 1265414643)

Field	Value
Entity Type	Organization
Organization	Northumberland County Mental Health Mental Retardation Program
Address	217 N Center St
City	Sunbury
State	PA
ZIP	17801
Taxonomy	Case Management Agency
NPI Enumerated	November 19, 2005

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W7210	N/A	89,430	$80	$6.9M
T1017	Targeted case management, each 15 minutes	10,980	$80	$878K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	3,770	$90	$354.1K
90834	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…	480	$80	$38.6K
H2010	Comprehensive medication services, per 15 minutes	350	$60	$20.2K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Northumberland County Mental Health Mental Retardation Program — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W7210	N/A	34	70	83,330	$80	$10M
T1017	Targeted case management, each 15 minutes	143	210	18,200	$100	$2.9M
90834	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…	491	690	2,240	$80	$1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	165	980	310	$50	$136.6K
H2010	Comprehensive medication services, per 15 minutes	13	20	570	$30	$31.1K

Nearby Providers

Other providers in the same ZIP code as Northumberland County Mental Health Mental Retardation Program, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mahmood Nasir	PA	Neurology Physician	$126.8K	$0
Stephen Lewis	PA	Pediatrics Physician	$77.7K	$0
Rodney Franklin	PA	Emergency Medicine Physician	$53.8K	$22.2K
Molly Breskiewicz	PA	Nurse Practitioner	$31.5K	$0

Northumberland County Mental Health Mental Retardation Program — Billing Profile & Reimbursement Data

Sign up for Northumberland County Mental Health Mental Retardation Program — Billing Profile & Reimbursement Data policy alerts

Northumberland County Mental Health Mental Retardation Program — Billing Profile & Reimbursement Data

Sign up for Northumberland County Mental Health Mental Retardation Program — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References