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.

Thedacare, Incorporated (NPI 1306959515)

Thedacare, Incorporated is a counselor provider located in Menasha, Wisconsin. This profile covers 0 Medicare and 32 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	Thedacare, Incorporated
Address	1095 Midway Rd
City	Menasha
State	WI
ZIP	54952
Taxonomy	Counselor
NPI Enumerated	August 15, 2006

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	35,450	$20	$638.1K
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…	23,660	$20	$402.2K
H0022	Alcohol and/or drug intervention service (planned facilitation)	8,340	$10	$75.1K
Q3014	Telehealth originating site facility fee	9,770	$10	$68.4K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	910	$60	$52.8K
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…	4,060	$10	$40.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	750	$40	$29.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,150	$10	$27.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	2,170	$10	$21.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	770	$30	$20K

Showing 1–10 of 32

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

Thedacare, Incorporated — 3 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	41	50	8,810	$110	$2.2M
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.	87	190	620	$40	$226.6K
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…	55	1,630	270	$40	$205.3K
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…	274	1,760	250	$40	$173.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	246	350	300	$50	$157.9K
H0022	Alcohol and/or drug intervention service (planned facilitation)	18	190	400	$30	$140.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	349	900	410	$70	$130.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	10	790	400	$40	$109.6K
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…	244	350	210	$60	$95.8K
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,…	365	690	160	$60	$90.4K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thedacare, Incorporated	WI	Family Medicine Physician	$0	$14.8M
Thedacare Regional Medical Center - Appleton, Inc.	WI	General Acute Care Hospital	$0	$11.5M
Thedacare Medical Center - Berlin, Inc.	WI	Critical Access Hospital	$0	$9.4M
Thedacare, Incorporated	WI	Community Based Hospice Care Agency	$0	$8.3M
Thedacare, Incorporated	WI	Durable Medical Equipment & Medical Supplies	$0	$7.4M
Paul Utrie	WI	Rheumatology Physician	$1.3M	$0
Mohsin Alhaddad	TN	Cardiovascular Disease Physician	$524.3K	$497.8K
Asher Shahzad	NV	Infectious Disease Physician	$437.5K	$483.4K
Donny Stokes	MS	Cardiovascular Disease Physician	$881.8K	$0
Richard Santa Cruz	WI	Cardiovascular Disease Physician	$477.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gold Cross Ambulance Service Inc	WI	Land Ambulance	$1.4M	$5.7M
Preferred Home Health Care, Inc	WI	Home Health Agency	$0	$4.2M
Joseph Neilitz	WI	Ophthalmology Physician	$257.8K	$0
Michele Holder	WI	Dermatology Physician	$153.7K	$0
Sorin Herscovici	WI	Endocrinology, Diabetes & Metabolism Physician	$79.7K	$2.8K
Cheryl-lynn Pitre	WI	Family Medicine Physician	$82.4K	$0
John Joseph	WI	Pain Medicine (Anesthesiology) Physician	$73.8K	$0
John Briggs	WI	Counseling Psychologist	$8.2K	$29.6K
John Beld	WI	Psychiatry Physician	$23.1K	$0
Yong Li	WI	Psychiatry Physician	$17.9K	$70

Thedacare, Incorporated — Billing Profile & Reimbursement Data

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Thedacare, Incorporated — 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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