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

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Focused On You, LLC. — Billing Profile & Reimbursement Data

NPI 1356825640 · Milton, WV · Case Management Agency

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Focused On You, LLC. is a case management agency provider located in Milton, West Virginia. This profile covers 0 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Field	Value
Entity Type	Organization
Organization	Focused On You, LLC.
Address	1709 Us Route 60 W
City	Milton
State	WV
ZIP	25541
Taxonomy	Case Management Agency
NPI Enumerated	September 21, 2018

Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

View: By Year1 / 3

Medicaid Revenue by Year vs. West Virginia Providers

0 of 5 years billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9002	Coordinated care fee, maintenance rate	8,020	$210	$1.7M
T1016	Case management, each 15 minutes	1,020	$70	$70.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Focused On You, LLC. — 0 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9002	Coordinated care fee, maintenance rate	23	120	2,950	$150	$901.9K
T1016	Case management, each 15 minutes	65	100	2,790	$90	$496.2K

Nearby Providers

Other providers in the same ZIP code as Focused On You, LLC., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Unlimited Possabilities, Inc.	WV	Community/Behavioral Health Agency	$0	$22.1M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$11M

Frequently Asked Questions

References

1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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