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

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

Choptank Community Health System Inc (NPI 1356388599)

Field	Value
Entity Type	Organization
Organization	Choptank Community Health System Inc
Address	301 Randolph St
City	Denton
State	MD
ZIP	21629
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$27.2M
Medicare	$0

Key Findings

CHOPTANK COMMUNITY HEALTH SYSTEM INC reports $27.2M in lifetime Medicaid revenue and has no Medicare billing on file; the provider is effectively single‑payer (Medicaid) in scale based on the available data. Its NPI was enumerated 2006-05-31 (~20 years ago), indicating roughly two decades of enrollment in federal programs.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99213, T1015, 99214) account for 84.4% of this provider's total Medicaid revenue. Specifically, 99213 represents $15.5M (57.3% of Medicaid revenue), T1015 $4.3M (15.8%), and 99214 $3.1M (11.3%), signaling that a small set of visit codes drives the bulk of receipts.

The code mix points to a primary‑care FQHC operational model dominated by established outpatient visits: 99213 has 97.2K claims at $160 avg paid/claim generating $15.5M, and 99214 has 19.8K claims at $155 avg paid/claim generating $3.1M. Coupled with T1015 (42.1K claims, $102 avg paid/claim, $4.3M) — a clinic visit/encounter all‑inclusive code — the profile is consistent with high-volume, routine ambulatory care delivery and bundled FQHC encounter billing.

Preventive and pediatric services are a meaningful secondary service line: preventive codes 99392 (3.9K claims, $176 avg paid/claim, $685.3K), 99391 (3.3K claims, $170 avg paid/claim, $568.7K), 99393 (2.9K claims, $177 avg paid/claim, $515.2K), and related codes appear across age groups. High volumes of vaccinations and specimen prep support this pattern (90471: 15.1K claims, $1 avg paid/claim, $15.1K; 99000: 11.4K claims, $1 avg paid/claim, $11.4K), indicating routine preventive workflows and immunization services integrated into primary care visits.

Telehealth, behavioral health, and care‑management activities are present but represent small shares of revenue: G2025 telehealth (1.6K claims, $15 avg paid/claim, $24.5K), G0470 mental health visits (649 claims, $32 avg paid/claim, $20.8K), and G0511 chronic care/behavioral integration (5.4K claims, $5 avg paid/claim, $27.1K) are all billed. These codes suggest the FQHC provides some remote and integrated behavioral/chronic care services, although they are not major revenue drivers relative to office visit codes.

State competitive standing is strong for core visit codes: 99213 ranks #14 of 3275 providers in‑state (100th percentile; extreme outlier) and 99214 ranks #85 of 3673 (98th percentile), indicating the provider is a dominant outlier in established visit volume within Maryland. Other codes show extreme outlier status as well (e.g., W7010 ranks #1 of 36, G0442 ranks #1 of 39), which reinforces unusually high activity on a handful of procedure lines versus peers.

Operationally, the sheer claim volume for 99213 (97.2K claims) and T1015 (42.1K claims) implies a large ongoing ambulatory throughput and a reliance on routine E/M encounters; this has staffing and capacity implications for appointment access, front‑office intake, and chronic care workflows. Because 84.4% of Medicaid revenue concentrates in the top three codes and there is no Medicare revenue reported, the organization’s financial performance is sensitive to changes in Medicaid visit volumes or reimbursement policies affecting those specific codes.

Medicaid: Complete Services Breakdown

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

76 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	97,170	$160	$15.5M
T1015	Clinic visit/encounter, all-inclusive	42,130	$100	$4.3M
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…	19,760	$160	$3.1M
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,…	6,190	$160	$990.9K
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…	3,890	$180	$685.3K
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…	3,350	$170	$568.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,910	$180	$515.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,010	$170	$350.3K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,450	$180	$256.3K
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.	1,260	$150	$193.4K

Showing 1–10 of 76

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maryland Distribution

Choptank Community Health System Inc — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

76 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	10	60	380	$170	$4.1M
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…	2,175	2,200	890	$110	$596.1K
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…	85	3,670	680	$90	$310K
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…	14	3,280	610	$80	$296.1K
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…	40	330	800	$110	$228.7K
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…	39	290	730	$100	$212.2K
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…	405	610	520	$50	$178.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	55	350	490	$110	$172.3K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	56	320	290	$120	$128K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2	40	100	$30	$119.8K

Showing 1–10 of 76

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Choptank Community Health System, Inc.	MD	Federally Qualified Health Center (FQHC)	$0	$18.5M
Adebowale Prest	MD	Family Medicine Physician	$2.8M	$0
Glenda Mccarter	MD	Nurse Practitioner	$1.3M	$0
Cameron Moore	PA	Family Medicine Physician	$411.7K	$92.2K
Katelin Haley	DE	Family Medicine Physician	$231.3K	$0
Jeffrey Denton	MD	Family Medicine Physician	$179.9K	$0
Donna Stubbs	MD	Nurse Practitioner	$148.8K	$0
James Lacey	MD	Family Medicine Physician	$108.6K	$0
Jennifer Funaioli-sheehan	NH	Family Medicine Physician	$82.8K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caroline County Public Schools	MD	Local Education Agency (LEA)	$0	$5.6M
Caroline County Commissioners Dept.	MD	Land Ambulance	$822.9K	$870.7K
Zachary Schall	MD	Physical Therapist	$208.7K	$0
Shore Health System Inc	MD	Radiology Clinic/Center	$51.9K	$40.4K

Choptank Community Health System Inc — Billing Profile & Reimbursement Data

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Choptank Community Health System Inc — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References