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.

Southwest Colorado Mental Health Center, Inc (NPI 1316374283)

Field	Value
Entity Type	Organization
Organization	Southwest Colorado Mental Health Center, Inc
Address	1970 E 3rd Ave
City	Durango
State	CO
ZIP	81301
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 8, 2013

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 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…	8,630	$210	$1.8M
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…	7,430	$210	$1.6M
D0999	N/A	1,040	$360	$373.7K
90832	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…	1,690	$130	$212.7K
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,…	550	$200	$111.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	350	$240	$84.5K
99204	The provider sees a new 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 provider…	250	$210	$51.7K
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…	100	$200	$20.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	410	$50	$20.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	1,740	$10	$19.2K

Showing 1–10 of 22

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

Southwest Colorado Mental Health Center, Inc — 0 of 19 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	99	150	2,140	$260	$2M
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…	243	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…	221	2,630	430	$90	$268.2K
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…	577	590	200	$80	$119.9K
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,…	171	690	140	$90	$118.4K
90832	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…	76	400	290	$70	$98.6K
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…	73	130	120	$140	$73.8K
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…	548	880	110	$80	$64.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	441	1,130	300	$50	$59.4K
99204	The provider sees a new 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 provider…	295	990	90	$120	$57.9K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southwest Colorado Mental Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Colorado Mental Health Center, Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$18.2M
Southwest Colorado Mental Health Center, Inc	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.5M
Southwest Colorado Mental Health Center, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$4.5M
Benjamin Phillips	WI	Ophthalmology Physician	$139.5K	$0
Amber Reiss-holt	CO	Surgical Critical Care Physician	$111.4K	$60
Barton Giessel	CO	Family Medicine Physician	$15.6K	$0
Jill Rimmey	CO	Family Medicine Physician	$610	$3.2K
Donald Kring	CO	Anesthesiology Physician	$2.3K	$0
Kirstin Howell	CO	Family Nurse Practitioner	$2.2K	$0
Laura Mckeon	CO	Clinical Social Worker	$1.7K	$0

Nearby Providers

Other providers in the same ZIP code as Southwest Colorado Mental Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Catholic Health Initiatives Colorado	CO	General Acute Care Hospital	$0	$6M
Pediatric Partners Of The Southwest	CO	Pediatrics Physician	$0	$5.8M
Nicholas Hugentobler	CO	Foot & Ankle Surgery Podiatrist	$1.9M	$0
Kyle Piwonka	CO	Retina Specialist (Ophthalmology) Physician	$1.7M	$0
Clayton Labaume	CO	Surgical Physician Assistant	$1.4M	$0
Sano Vita Inc	CO	Community/Retail Pharmacy	$86.6K	$359.1K
Joshua Zastrocky	CO	Ophthalmology Physician	$352.5K	$0
Jonathan Clark	CO	Radiation Oncology Physician	$340.9K	$0
Brinceton Phipps	CO	Orthopaedic Surgery Physician	$332.8K	$0
John Brach	CO	Ophthalmology Physician	$313.8K	$0

Southwest Colorado Mental Health Center, Inc — Billing Profile & Reimbursement Data

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Southwest Colorado Mental Health Center, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References