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

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

Aurora Advanced Healthcare, Inc. (NPI 1265629133)

Key Findings

Field	Value
Entity Type	Organization
Organization	Aurora Advanced Healthcare, Inc.
Address	3003 W Good Hope Rd
City	Milwaukee
State	WI
ZIP	53209
Taxonomy	Family Medicine Physician
NPI Enumerated	September 25, 2007

Payer Source	Total Paid
Medicaid	$28.3M
Medicare	$0

AURORA ADVANCED HEALTHCARE, INC. reports no Medicare billing on file and $28.3M in lifetime Medicaid revenue, making its operating footprint in these data effectively single‑payer (Medicaid) rather than split across Medicare and Medicaid. The absence of Medicare claims suggests this entity’s measurable public-payer activity is overwhelmingly concentrated in Medicaid.

Revenue concentration is heavily driven by evaluation-and-management office visits: the top three Medicaid codes (99214, 99213, 99203) together account for 67.0% of the provider’s total Medicaid revenue, with 99214 alone contributing $9.2M (38.2%) and 99213 contributing $6M (25.2%). This indicates a tight revenue dependence on high-volume ambulatory E/M encounters.

Operationally, the code mix points to a high-volume primary care/ambulatory practice model that also performs substantial diagnostic and procedural care. Large claim volumes for office visits (99214: 212.9K claims; 99213: 208.4K claims) are complemented by significant endoscopy (43239: 5.3K claims; 45380: 3.3K claims), joint injections (20610: 12K claims), and a broad array of laboratory and imaging services (99000: 115.4K claims; 85025: 52.8K claims; 80053: 30.7K claims), implying integrated outpatient service lines rather than a narrow single-procedure focus.

Competitive standing in-state is dominant for several high-revenue codes: the practice ranks #5 of 1628 providers for 99214 and #5 of 1755 for 99213 (each labeled 100th percentile, extreme outlier), and ranks #1 of 86 providers for 20610 (100th percentile). Multiple additional codes register at very high percentiles — for example, 43239 ranks #4 of 116 (97th percentile) and 87651 ranks #2 of 163 (99th percentile) — underscoring that the provider operates far above typical state volumes for a range of services.

Several specific codes are flagged as statistical outliers in the available data and reinforce the profile of unusually high throughput: 99214, 99213, 99203, 43239, 87651, 20610, 99000, 0240U and 92004 are all described as extreme outliers or notably above typical state volume in their rank notes. These labels indicate the provider’s activity levels for common E/M, procedural, and lab services are exceptional compared with in-state peers, which is important when benchmarking utilization and network capacity.

Although the practice is coded as Family Medicine Physician, the breadth and intensity of services billed (high-volume E/M plus endoscopy, colonoscopy, joint injections, extensive lab testing, imaging, and specialty-level ophthalmology evaluation code 92004) suggest either a large multi-site ambulatory group, an integrated clinic that billings multiple service lines, or substantial professional relationships with procedural units. The data do not specify organizational structure, but the mix is inconsistent with a small, single‑physician office and instead aligns with a sizable ambulatory operation.

Tenure of the NPI is long-standing: the provider’s NPI was enumerated on 2007-09-25 (~19 years ago). The extended active enrollment period paired with large Medicaid volumes suggests established patient panels and sustained Medicaid contracting rather than a recent market entrant.

From a payer-management perspective, the combination of concentrated revenue in a few high-volume E/M codes and classification as extreme outlier for those codes implies this provider is a critical Medicaid access point for primary care in Milwaukee and Wisconsin at large. Any network or utilization management decisions should account for the provider’s outsized share of routine outpatient encounters and its ancillary diagnostic/procedural capacity when assessing capacity, risk, and referral patterns.

Medicaid: Complete Services Breakdown

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

276 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…	212,880	$40	$9.2M
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…	208,400	$30	$6M
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…	16,010	$50	$848.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	5,300	$160	$831.8K
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.	24,470	$30	$782.9K
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…	3,280	$200	$652.7K
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…	7,670	$70	$528.9K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	12,020	$40	$504.7K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	115,400	$1	$461.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	20,820	$20	$416.3K

Showing 1–10 of 276

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Aurora Advanced Healthcare, Inc. — 12 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

276 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	284	360	1,550	$70	$614.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	276	430	760	$60	$484.6K
J0585	Injection, onabotulinumtoxina, 1 unit	23	30	550	$240	$428.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	187	190	1,790	$90	$390.9K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	295	330	1,350	$60	$338K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	31	260	3,590	$20	$232.2K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	30	40	930	$100	$214.5K
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…	5	1,630	270	$40	$205.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	82	160	990	$30	$191.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	4	120	400	$180	$186.8K

Showing 1–10 of 276

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Bahr	WI	Internal Medicine Physician	$3.1M	$356.4K
Kalid Adab	WI	Hematology & Oncology Physician	$259.5K	$1.2M
Scott Moretti	WI	Ophthalmology Physician	$395.8K	$0
Aswin Kumar	WI	Diagnostic Radiology Physician	$387K	$100
Ahmad Khraisat	WI	Interventional Cardiology Physician	$382.4K	$0
Rahul Sawlani	WI	Diagnostic Radiology Physician	$329.3K	$29.7K
Nausheen Abbas	WI	Ophthalmology Physician	$355.7K	$0
John Lewis	WI	Diagnostic Radiology Physician	$103.1K	$154.6K
Kamal Amin	WI	Nephrology Physician	$246.2K	$1.4K
Mark Nunag	WI	Nephrology Physician	$241.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shorehaven Behavioral Health Inc	WI	Clinical Psychologist	$0	$5.2M
Total Renal Care Inc	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.1M
Emmanuel Igwike	WI	General Practice Dentistry	$0	$3.7M
Sebastian Family Psychology Practice, LLC	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$2.1M
Baby Fever LLC	WI	Case Management Agency	$0	$1.9M
Ara-milwaukee Dialysis LLC	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.8M
Brown Deer Dental Health Center, Sc	WI	Dental Clinic/Center	$0	$1.8M
Adedapo Okusanya	WI	Family Medicine Physician	$20.4K	$581.9K
Daniel Gitter	WI	Dermatology Physician	$174K	$0
Edward Braza	WI	Ophthalmology Physician	$174K	$0

Aurora Advanced Healthcare, Inc. — 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