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.

Arca (NPI 1306955026)

Field	Value
Entity Type	Organization
Organization	Arca
Address	11300 Lomas Blvd Ne
City	Albuquerque
State	NM
ZIP	87112
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	August 29, 2006

Payer Source	Total Paid
Medicaid	$91.7M
Medicare	$0

Key Findings

This provider is effectively single-payer: there is no Medicare billing on file and all reported lifetime revenue is from Medicaid, totaling $91.7M. The absence of any Medicare claims indicates the organization operates almost exclusively within the Medicaid-funded IDD service system rather than the Medicare outpatient or institutional markets.

Revenue is extremely concentrated in a small set of waiver and residential codes: the precomputed top three Medicaid codes account for 92.7% of this provider's total Medicaid revenue. Specifically, T2016 generated $63.7M (69.4% of Medicaid revenue) from 208.1K claims, T2033 generated $15.4M (16.8%) from 107.1K claims, and S5125 generated $5.9M (6.4%) from 62.5K claims.

The code mix and dominant codes point to a residential habilitation and attendant-care business model: T2016 (Habilitation, residential, waiver; per diem) and T2033 (Residential care, NOS, waiver; per diem) together comprise the majority of billed services, while S5125 (Attendant care services; per 15 minutes) supplies a sizable share of direct support time. This pattern is consistent with an Intellectual and/or Developmental Disabilities community-based residential treatment facility operating large per‑diem residential programs supplemented by attendant care.

Competitive standing for T2016 is exceptional within the state: the provider ranks #1 of 40 providers and is described as an "extreme outlier" at the 100th percentile for T2016 volume, indicating market dominance in residential habilitation per diem billing. By contrast, for T2033 the provider ranks #4 of 39 (92th percentile) and for S5125 it ranks #11 of 45 (77th percentile), both characterized in the source as typical or unremarkable volumes relative to peers.

Operational scale is substantial when measured by claim counts: 208.1K claims for T2016 and 107.1K claims for T2033 reflect sustained, high-volume residential utilization rather than episodic or low-frequency services. Those claim volumes, paired with the provider's roughly 20-year tenure (NPI enumerated 2006-08-29), suggest an established, large-scale presence in New Mexico's Medicaid IDD residential market.

Concentration risk is material because a single code family drives most revenue: with 92.7% of Medicaid revenue coming from three codes, changes to waiver policy, per-diem rates, or eligibility for T2016/T2033 services could materially affect the provider's financial performance. The heavy reliance on waiver per-diem billing also implies sensitivity to state-level reimbursement or authorization changes that target residential habilitation programs.

There are a few ancillary service lines where this provider is notably above typical state volume, which could indicate internal clinical capacity beyond core residential services: T1002 (Rn services, up to 15 minutes) appears as $510.1K in revenue and ranks #3 of 38 providers (95th percentile), described as "notably above typical". Other codes such as H2021 and T2025 contribute smaller shares ($2.8M and $2.4M respectively) and sit at more typical state percentiles, indicating some diversification within waiver service categories.

The long NPI tenure (~20 years) combined with extreme outlier status on the primary residential habilitation code suggests institutional scale and deep integration with state waiver programs. For payers and competitors, the provider should be treated as an entrenched large residential waiver operator in New Mexico whose positioning is driven by high-volume per‑diem habilitation services rather than fee-for-service clinical billing.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	208,070	$310	$63.7M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	107,110	$140	$15.4M
S5125	Attendant care services; per 15 minutes	62,490	$90	$5.9M
H2021	Community-based wrap-around services, per 15 minutes	23,970	$120	$2.8M
T2025	Waiver services; not otherwise specified (nos)	2,660	$920	$2.4M
T2021	Day habilitation, waiver; per 15 minutes	10,980	$80	$911.3K
T1002	Rn services, up to 15 minutes	7,390	$70	$510.1K
T1003	Lpn/lvn services, up to 15 minutes	440	$80	$35.9K
S9470	Nutritional counseling, dietitian visit	30	$30	$1.1K
SCBUN	N/A	60	$0	$0

Showing 1–10 of 11

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

Arca — 1 of 9 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	1	40	54,080	$360	$22.1M
T2033	Residential care, not otherwise specified (nos), waiver; per diem	4	40	11,070	$280	$10.8M
H2021	Community-based wrap-around services, per 15 minutes	14	60	6,750	$340	$4.4M
S5125	Attendant care services; per 15 minutes	11	50	10,600	$100	$4.3M
T2021	Day habilitation, waiver; per 15 minutes	19	50	6,810	$120	$1.6M
T2025	Waiver services; not otherwise specified (nos)	8	40	1,010	$360	$1.6M
T1002	Rn services, up to 15 minutes	3	40	1,350	$150	$368.7K
T1003	Lpn/lvn services, up to 15 minutes	7	10	1,040	$120	$150.7K
S9470	Nutritional counseling, dietitian visit	3	10	1,260	$50	$64.9K
SCBUN	N/A	1	10	60	$0	$0

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Arca, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
El Mirador Incorporated	NM	Home Health Agency	$0	$100.9M
St. Anthony's Home Healthcare Service, LLC	NM	Home Health Agency	$0	$51.4M
Unica	NM	Community/Behavioral Health Agency	$0	$12.5M
Tasker Hatch Rowan LLC	NM	Dentist	$0	$9.8M
Quilted Care Ltd. Co.	NM	Assisted Living Facility	$0	$7.5M
Choice Recovery Path LLC	NM	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.4M
Bio-medical Applications Of New Mexico, Inc.	NM	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3.1M
Foust Behavioral Services, LLC	NM	Social Worker	$0	$1.7M
Modern Pain & Spine PC	NM	Interventional Pain Medicine Physician	$0	$1.6M
Trucare Dental Wyoming Blvd LLC	NM	Dentist	$0	$1.4M

Arca — Billing Profile & Reimbursement Data

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Arca — 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

Nearby Providers

Frequently Asked Questions

References