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

Why is the Medicaid comparison limited to 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. 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.

Greater Prince William Area Community Health Center Inc (NPI 1366591562)

Greater Prince William Area Community Health Center Inc is a federally qualified health center (fqhc) provider located in Woodbridge, Virginia. This profile covers 0 Medicare and 132 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	Greater Prince William Area Community Health Center Inc
Address	3350 Commission Ct
City	Woodbridge
State	VA
ZIP	22192
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 9, 2007

Payer Source	Total Paid
Medicaid	$11.6M
Medicare	$0

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

132 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…	59,450	$60	$3.7M
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…	21,200	$100	$2M
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…	11,770	$80	$917.7K
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…	7,870	$80	$606.2K
59426	This service is considered a mini global code for the provider who provides seven or more antepartum visits. This can happen when the patient transfers out of the practice prior to delivery or the…	960	$600	$575.5K
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…	8,070	$70	$572.8K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	1,200	$220	$262.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,500	$80	$190.3K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	4,990	$20	$119.7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	8,730	$10	$104.7K

Showing 1–10 of 132

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Greater Prince William Area Community Health Center Inc — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

132 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	369	400	1,910	$50	$412.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	371	400	2,060	$60	$407.3K
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…	216	3,520	370	$70	$280.7K
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…	21	1,340	710	$90	$245K
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…	35	4,010	290	$50	$199.8K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	23	60	280	$110	$167.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	54	140	160	$70	$144.5K
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…	29	650	150	$80	$115.4K
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…	188	330	270	$40	$112.2K
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…	209	660	310	$60	$110.9K

Showing 1–10 of 132

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Scarlet Haven Residential Services	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$47.8M
Savida Health, PC	VA	Addiction Medicine (Internal Medicine) Physician	$0	$46.6M
Maxim Healthcare Services, Inc.	VA	Home Health Agency	$0	$42.2M
D&t Home Care Business LLC	VA	Home Health Aide	$0	$20.7M
Isada Healthcare Services, Inc.	VA	Continence Care Registered Nurse	$0	$12.8M
Gina C Pham Dds PC	VA	Pediatric Dentistry	$0	$12.3M
Serenity Home Healthcare, LLC	VA	Home Health Agency	$0	$10.9M
Herald Healthcare LLC	VA	Home Health Agency	$0	$9.4M
Lyon Home Health Care LLC	VA	Home Health Aide	$0	$9.4M
Arm Baby Eldery Home Health LLC	VA	Home Health Agency	$0	$7.2M

Greater Prince William Area Community Health Center Inc — Billing Profile & Reimbursement Data

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Greater Prince William Area 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

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