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

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

Consumer Direct For Florida (NPI 1376980409)

Field	Value
Entity Type	Organization
Organization	Consumer Direct For Florida
Address	4577 N Nob Hill Rd Ste 206
City	Sunrise
State	FL
ZIP	33351
Taxonomy	Home Health Agency
NPI Enumerated	May 30, 2013

Payer Source	Total Paid
Medicaid	$156.3M
Medicare	$0

Key Findings

CONSUMER DIRECT FOR FLORIDA is effectively a single-payer Medicaid-focused home health agency: it has no Medicare billing on file and reports total Medicaid revenue of $156.3M, indicating Medicaid is its sole documented payer footprint in the dataset. The absence of Medicare activity suggests the organization targets Medicaid programs (including waiver and personal care services) rather than traditional Medicare home health lines.

Revenue is highly concentrated in a small set of Medicaid service codes: the precomputed top 3 codes account for 89.7% of the provider's Medicaid revenue, signaling a narrow service mix where a few recurring, time-based personal care and homemaker codes drive the vast majority of income. That concentration implies operational scale built around high-volume, per-15-minute direct care delivery rather than a broad array of clinical procedures.

T1019 is the dominant revenue driver for this provider, with $94.6M in revenue (60.6% of the provider's Medicaid revenue) and 2M claims; the provider ranks #1 of 762 in-state and is described as an extreme outlier. This combination of rank, volume, and share identifies the organization as a statewide leader for personal care services and suggests infrastructure and staffing optimized for large-scale personal care delivery.

S5130 (homemaker service) and S5135 (companion care) are the second and third largest contributors, at $33.1M (21.2% of Medicaid revenue) and $12.4M (7.9%) respectively, with the provider ranking #2 statewide for both codes and flagged as extreme outlier volume. These placements indicate the provider competes at the very top of the market for nonmedical assistance and supervision services, reinforcing a business model concentrated on long-duration, routine in-home support.

Other Medicaid codes show more modest contributions but highlight supplemental capabilities: G9012 generated $11.4M (7.3%) and ranks #3 of 47 providers (notably above typical state volume), while T2040 contributed $4M (2.5%) and ranks #1 of 2 providers (typical volume). These mid-tier code positions suggest the provider also participates in case management and financial management/self-directed waiver services, complementing its high-volume personal care offerings.

The provider’s NPI was enumerated on 2013-05-30 (~13 years ago), indicating over a decade of active enrollment. That tenure, combined with concentrated, high-volume claims counts (e.g., 2M claims for T1019 and 1.3M for S5130), supports the view of an established operator with mature workflows for high-frequency, low-per-claim services.

Competitive standing within Florida is dominant for core personal care and homemaker services: multiple codes are ranked at #1 or #2 in-state and are labeled extreme outliers, which positions the provider as a major market participant in the state’s Medicaid personal care ecosystem rather than a marginal provider. Analysts should treat this provider as a top-tier statewide competitor for time-based in-home support services.

The mix of codes—primarily T1019, S5130, and S5135—reflects an operational emphasis on per-15-minute, non-skilled personal care, homemaker tasks, and companion services rather than skilled nursing or therapy. This suggests cost structure and staffing models focused on large numbers of aides or attendants delivering frequent short-interval visits, and revenue sensitivity to state Medicaid rate changes or waiver program policy shifts affecting time-based personal care reimbursement.

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	1,971,860	$50	$94.6M
S5130	Homemaker service, nos; per 15 minutes	1,274,860	$30	$33.1M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	365,370	$30	$12.4M
G9012	Other specified case management service not elsewhere classified	71,080	$160	$11.4M
T2040	Financial management, self-directed, waiver; per 15 minutes	25,660	$160	$4M
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	2,290	$210	$472.2K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,870	$90	$174.3K
T1002	Rn services, up to 15 minutes	180	$440	$77K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Consumer Direct For Florida — 5 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	1	760	13,520	$50	$2.5M
T2040	Financial management, self-directed, waiver; per 15 minutes	1	10	13,220	$160	$2.2M
G9012	Other specified case management service not elsewhere classified	3	50	1,820	$150	$1.4M
S5130	Homemaker service, nos; per 15 minutes	2	1,070	11,250	$40	$1.3M
S5135	Companion care, adult (e.g., iadl/adl); per 15 minutes	2	540	5,780	$40	$596.2K
T1028	Assessment of home, physical and family environment, to determine suitability to meet patient's medical needs	1	10	2,290	$210	$471.3K
T1002	Rn services, up to 15 minutes	47	50	4,450	$10	$47.1K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	5	60	160	$30	$16.9K

Nearby Providers

Other providers in the same ZIP code as Consumer Direct For Florida, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cr & Ra Investments LLC	FL	Home Health Agency	$0	$57M
Tirso Lara	FL	Ophthalmology Physician	$1.5M	$0
Richard Bransgrove	FL	Optometrist	$562.3K	$857K
Baptist Surgery And Endoscopy Centers LLC	FL	Ophthalmologic Surgery Clinic/Center	$1.2M	$0
Elisabeth Nguyen	FL	Optometrist	$231.8K	$363.4K
Ross Nochimson	FL	Internal Medicine Physician	$284.2K	$0
Marlene Moster	FL	Ophthalmology Physician	$249.9K	$0
Marjorie Gillespie	FL	Psychiatric/Mental Health Nurse Practitioner	$19.7K	$172.2K
Henry Spratt	FL	Ophthalmology Physician	$184.1K	$0
Everold Haffizulla	FL	Family Medicine Physician	$102.6K	$0

Consumer Direct For Florida — Billing Profile & Reimbursement Data

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Consumer Direct For Florida — 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

Nearby Providers

Frequently Asked Questions

References