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

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

Lone Star Community Health Center, Inc. (NPI 1326045774)

Field	Value
Entity Type	Organization
Organization	Lone Star Community Health Center, Inc.
Address	605 S Conroe Medical Dr
City	Conroe
State	TX
ZIP	77304
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 30, 2005

Payer Source	Total Paid
Medicaid	$31M
Medicare	$0

Medicaid: Complete Services Breakdown

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

114 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	133,140	$170	$22.6M
D0999	N/A	12,180	$200	$2.4M
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…	59,590	$40	$2.3M
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…	9,720	$90	$913.5K
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…	8,190	$80	$630.3K
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,…	11,580	$30	$393.6K
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…	5,910	$40	$260.2K
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…	3,450	$60	$189.9K
99381	The provider performs a well–baby visit for a child under the age of one.	1,630	$120	$187.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,590	$100	$163.3K

Showing 1–10 of 114

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Lone Star Community Health Center, Inc. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

114 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	13	770	2,990	$170	$2.6M
D0999	N/A	9	180	390	$190	$405.3K
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…	88	6,040	710	$40	$232.8K
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…	141	1,500	880	$80	$185.8K
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…	58	1,360	800	$80	$185.6K
D2392	Post 2 surface resin‑based composite	2,140	2,600	490	$90	$164.2K
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…	457	5,810	540	$50	$155.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	167	1,540	650	$80	$150.4K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	22	30	40	$660	$131.4K
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…	923	1,700	610	$80	$111.9K

Showing 1–10 of 114

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tina Spruell	TX	Family Nurse Practitioner	$854.3K	$0

Nearby Providers

Other providers in the same ZIP code as Lone Star Community Health Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jtj Staffing, Inc.	TX	Home Health Agency	$0	$50.1M
Advocate Pediatric Home Care LLC	TX	Home Health Agency	$0	$30.9M
Chca Conroe LP	TX	General Acute Care Hospital	$0	$12.8M
Montgomery County Hospital District	TX	Ambulance	$4.4M	$7.4M
Conroe Independent School District	TX	Local Education Agency (LEA)	$0	$11.4M
Ajay Kwatra	TX	Urology Physician	$3M	$0
North Pines Surgery Center, LLC	TX	Ambulatory Surgical Clinic/Center	$2.7M	$0
Conroe Surgery Center 2, LLC	TX	Ambulatory Surgical Clinic/Center	$2M	$0
Arindam Banerjee	TX	Interventional Cardiology Physician	$1.3M	$0
Ashesh Desai	TX	Pulmonary Disease Physician	$999.8K	$0

Lone Star Community Health Center, Inc. — Billing Profile & Reimbursement Data

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Lone Star Community 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