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

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

Father Flanagan's Boys' Home (NPI 1295821825)

Key Findings

Field	Value
Entity Type	Organization
Organization	Father Flanagan's Boys' Home
Address	555 N 30th St
City	Omaha
State	NE
ZIP	68131
Taxonomy	Pediatrics Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$23.1M
Medicare	$0

This provider is effectively a Medicaid-only biller: Total Medicaid revenue is $23.1M while there is no Medicare billing on file. The NPI was enumerated on 2006-10-04 (≈20 years ago), indicating a long tenure of claims activity concentrated in state Medicaid programs rather than Medicare.

Revenue is highly concentrated in a small set of office-visit and anesthesia codes: the precomputed top 3 Medicaid codes account for 63.6% of this provider's total Medicaid revenue, driven by 99214 ($7M; 32.6%), 99213 ($5.7M; 26.6%), and 00170 ($950.6K; 4.4%). This concentration means a few service lines dominate the provider’s Medicaid financial profile.

The code mix points to a pediatric primary-care and behavioral-health model: very high volumes of E/M codes (99214, 99213, 99203, 99215) alongside preventive care codes (99391, 99392, 99393, 99394) suggest continuous well-child and chronic care management. Significant utilization of psychotherapy add-on and mental health codes (90833, 90836, 90847, 90791/90792, 96130, 96127) indicates integrated behavioral health services are a material part of clinical activity and revenue.

Despite the pediatrics taxonomy, the presence of procedural and anesthesia billing flags procedural capacity or partnerships for operative care: 00170 (anesthesia for intraoral procedures) accounts for $950.6K (4.4% of revenue) and 69436 (tympanostomy with tube) contributes $218.9K (1.0%). These procedure-related codes—together with 43239 (biopsy via endoscopy) at $168.2K—suggest the organization bills for procedure-associated services in addition to outpatient visits.

The provider is a statewide volume outlier for many key codes and appears to be a dominant Medicaid participant for core pediatric services: 99214 ranks #3 of 596 providers in-state (100th percentile; extreme outlier), 99213 ranks #5 of 696 (99th percentile; extreme outlier), and several behavioral-health and complex visit codes (90836, 99205, 96130) rank at the top of their peer groups (many at 100th percentile). These ranks indicate unusually large state-level market share on those codes rather than modest, typical participation.

Operational scale is substantial on a claims basis: 99214 shows 85.2K claims and 99213 shows 98.4K claims, implying very high ambulatory throughput for established pediatric visits. High claim counts for vaccines (90686, 15.9K claims) and therapy/assessment services (92507 7.5K claims; 96130 1.5K claims) further reinforce the picture of a high-volume, multi-service pediatric practice.

Some service lines are comparatively routine versus peers: codes like 00170 and 69436 are ranked in the 80s–90s percentiles and are described as typical or unremarkable volumes for those code groups, indicating that while the practice is exceptional for ambulatory and behavioral codes, its procedural volumes are more typical for in-state peers. This suggests the provider’s competitive differentiation is strongest in outpatient pediatrics and behavioral-health delivery rather than in surgical throughput.

Given the single-payer concentration in Medicaid (no Medicare revenue reported), changes to state Medicaid reimbursement policy, prior authorization, or visit-reimbursement rules could have outsized impact on this provider. The heavy reliance on a few high-volume E/M codes and on Medicaid revenue overall makes payer-policy shifts a significant business risk and planning consideration.

Medicaid: Complete Services Breakdown

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

127 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…	85,190	$80	$7M
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…	98,390	$60	$5.7M
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	4,440	$210	$950.6K
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…	7,170	$100	$688.2K
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…	9,680	$60	$609.8K
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…	6,260	$100	$595K
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…	6,820	$90	$586.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,870	$100	$557.7K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	7,060	$70	$522.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	5,080	$100	$517.6K

Showing 1–10 of 127

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Father Flanagan's Boys' Home — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

127 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	4	20	240	$900	$448.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	15	40	2,880	$40	$386.7K
01922	The provider performs anesthesia services for a patient undergoing non–invasive imaging or radiation therapy.	3	10	1,210	$240	$313.4K
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…	5	700	660	$70	$305.1K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	3	10	50	$220	$285K
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.	2	30	280	$450	$266.7K
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	600	610	$70	$251.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	22	30	630	$50	$250.1K
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…	8	70	360	$80	$234.7K
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…	7	70	230	$90	$222.7K

Showing 1–10 of 127

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Father Flanagan's Boys' Home	NE	Children's Hospital	$0	$16.2M
Father Flanagan's Boys Home	NE	Psychologist	$0	$3M
Father Flanagan's Boys Home	NE	Counselor	$0	$1M
Alexander Bernal	NE	Gastroenterology Physician	$397.9K	$0
Father Flanagan's Boys Home	NE	Psychologist	$0	$263.9K
Dominick Dimaio	NE	Anatomic Pathology Physician	$173.3K	$0
Brian Kelly	NE	Allergy & Immunology Physician	$159.1K	$0
Ji Lee	IL	Pain Medicine (Anesthesiology) Physician	$139.7K	$13.2K
Chad Eicher	NE	Vascular & Interventional Radiology Physician	$117.5K	$0
William Leight	NE	Otolaryngology Physician	$89.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Physician Associates Of Nebraska PC	NE	Emergency Medicine Physician	$0	$4.9M
Dialysis Clinic Inc.	NE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.9M
Alegent Health Bergan Mercy Health System	NE	Psychiatry Physician	$0	$3.4M
Matthew Appenzeller	NE	Ophthalmology Physician	$2.5M	$0
Mark Emig	NE	Ophthalmology Physician	$2.2M	$0
Midwest Eye Surgery Center, LLC	NE	Ambulatory Surgical Clinic/Center	$1.8M	$0
David Ingvoldstad	NE	Ophthalmology Physician	$1.8M	$0
Haysam Akkad	NE	Interventional Cardiology Physician	$817.6K	$0
Pamela Helem	NE	Mental Health Counselor	$0	$680.9K
Michael Feilmeier	NE	Ophthalmology Physician	$617.6K	$0

Father Flanagan's Boys' Home — Billing Profile & Reimbursement Data

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Father Flanagan's Boys' Home — 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