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

Why is the Medicaid comparison limited to New Mexico 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. New Mexico (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.

Tohatchi Area Of Opportunity & Services (NPI 1306318423)

Field	Value
Entity Type	Organization
Organization	Tohatchi Area Of Opportunity & Services
Address	1658 S Second St
City	Gallup
State	NM
ZIP	87301
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	December 31, 2018

Payer Source	Total Paid
Medicaid	$10.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	35,920	$270	$9.6M
H2021	Community-based wrap-around services, per 15 minutes	5,480	$90	$493.6K
T2021	Day habilitation, waiver; per 15 minutes	4,190	$60	$230.5K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Mexico Distribution

Tohatchi Area Of Opportunity & Services — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Mexico

Full comparison — all codes billed, vs. New Mexico median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	30	40	54,080	$360	$22.1M
H2021	Community-based wrap-around services, per 15 minutes	34	60	6,750	$340	$4.4M
T2021	Day habilitation, waiver; per 15 minutes	31	50	6,810	$120	$1.6M

Nearby Providers

Other providers in the same ZIP code as Tohatchi Area Of Opportunity & Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ramah Care Services, Inc.	NM	Assisted Living Facility	$0	$33.4M
Dhhs,phs,naihs, Gallup Indian Medical Center	NM	General Acute Care Hospital	$0	$32.6M
Rehoboth Mckinley Christian Health Care Services, Inc.	NM	Critical Access Hospital	$0	$31.9M
Red Rocks Dialysis, LLC	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$17M
Native Resource Development Company Inc.	NM	In Home Supportive Care Agency	$0	$14.7M
Guardian Flight LLC	NM	Air Ambulance	$2.1M	$11M
Special Care At Home, Inc	NM	In Home Supportive Care Agency	$0	$11M
Jjdac, LLC	NM	Land Ambulance	$544.5K	$9.6M
Rehoboth Mckinley Christian Health Care Services, Inc	NM	Rural Health Clinic/Center	$0	$9.9M
Zhon Home Care Corporation	NM	In Home Supportive Care Agency	$0	$8.7M

Tohatchi Area Of Opportunity & Services — Billing Profile & Reimbursement Data

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Tohatchi Area Of Opportunity & Services — Billing Profile & Reimbursement Data

Sign up for Tohatchi Area Of Opportunity & Services — 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