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

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

Grace Health Clinic (NPI 1275864449)

Grace Health Clinic is a health service clinic/center provider located in Aurora, Colorado. This profile covers 0 Medicare and 81 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	Grace Health Clinic
Address	3191 S Vaughn Way Ste 101
City	Aurora
State	CO
ZIP	80014
Taxonomy	Health Service Clinic/Center
NPI Enumerated	January 27, 2010

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

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

81 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…	12,340	$80	$974.9K
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…	5,310	$110	$584K
99402	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	11,040	$50	$540.7K
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…	8,530	$50	$452.1K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	9,010	$30	$225.3K
99205	The provider sees a new 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 provider…	1,140	$170	$187.8K
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,…	5,620	$30	$179.7K
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.	10,030	$20	$170.6K
84144	The lab analyst performs a test to evaluate the level of progesterone in a patient specimen, such as serum, saliva, or urine.	8,310	$20	$149.5K
84481	The lab analyst performs a test to measure free T3 in patient blood.	8,720	$20	$130.7K

Showing 1–10 of 81

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Grace Health Clinic — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

81 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	211	2,520	330	$100	$352K
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…	152	2,630	430	$90	$268.2K
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…	239	260	380	$100	$161.6K
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,…	29	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	162	290	160	$110	$111.1K
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…	29	720	130	$100	$110K
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.	9	90	800	$30	$103.7K
80373	The lab analyst measures the amount of or detects the presence of tramadol, which is a centrally acting opioid pain medication, in the patient specimen.	12	20	2,610	$20	$102K
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.	172	330	530	$30	$100.6K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	4	90	90	$30	$94.3K

Showing 1–10 of 81

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Teamselect Home Care Of Colorado, LLC	CO	Home Health Agency	$0	$194.9M
Clinton Home Care, Inc.	CO	In Home Supportive Care Agency	$0	$60.3M
Smith Agency	CO	Foster Care Agency	$0	$51.9M
Colorado Spirit Home Care	CO	In Home Supportive Care Agency	$0	$46.9M
Alternative Choice Home Care Nursing, LLC	CO	Home Health Agency	$0	$42.7M
Care On Call Colorado, LLC	CO	In Home Supportive Care Agency	$0	$33.8M
Atlas Home Health, Inc.	CO	Home Health Agency	$0	$31.3M
Mercy Home Services	CO	In Home Supportive Care Agency	$0	$27.9M
Community Support Services, Inc.	CO	Developmentally Disabled Services Day Training Agency	$0	$27M
Support Management	CO	Developmentally Disabled Services Day Training Agency	$0	$26.2M

Grace Health Clinic — Billing Profile & Reimbursement Data

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Grace Health Clinic — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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