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

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

Quality Case Management Inc (NPI 1386060424)

Field	Value
Entity Type	Organization
Organization	Quality Case Management Inc
Address	138 East 7th Ave
City	Afton
State	WY
ZIP	83110
Taxonomy	Case Management Agency
NPI Enumerated	March 13, 2014

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Key Findings

QUALITY CASE MANAGEMENT INC is categorized under the Case Management Agency taxonomy and its Medicaid billing is driven by a per-month case management service: T2022 (Case management, per month). The presence of T2022 as the listed code indicates the firm operates as a recurring monthly case-management provider rather than a multi-service clinical provider, focusing operationally on care coordination and ongoing service management for Medicaid beneficiaries.

Medicaid revenue is concentrated almost entirely in a single service line: the precomputed top-3 codes account for 100.0% of this provider's Medicaid revenue, and the dataset shows T2022 alone represents $2M of revenue. This means the business’s revenue profile is highly dependent on one code and one service category within Medicaid.

Payer mix is effectively single-payer: the provider reports $2M in total Medicaid revenue and has no Medicare billing on file. Because there is no Medicare activity, this entity’s financial exposure and growth are tied to Medicaid program rules, rates, and enrollment dynamics rather than a diversified payer portfolio.

On utilization and unit economics, the file reports 6.7K claims for T2022 with an average paid amount of $305 per claim, generating the $2M Medicaid revenue. Those figures reflect a steady claim volume and a consistent per-month payment level, signaling recurring billing patterns consistent with longitudinal case-management relationships.

In-state competitive standing for T2022 is strong: QUALITY CASE MANAGEMENT INC ranks #7 of 138 providers and sits in the 96th percentile for this code. The dataset’s label that its volume is "notably above typical state volume for this code" supports characterizing the provider as a major statewide participant in Medicaid case-management services rather than a marginal operator.

The provider has an NPI enumeration date of 2014-03-13 (~12 years ago), indicating it has been established in the market for over a decade. That tenure suggests operational persistence in the Medicaid case-management niche and experience delivering the billed service over multiple years.

The exclusive reliance on a single code and a single payer implies concentration risk: changes to Medicaid reimbursement policy, eligibility, or the allowed use of T2022 could materially affect the provider’s revenue given the 100.0% concentration. Analysts should treat future Medicaid policy shifts or contract renegotiations as key business risks when modelling the provider’s revenue sustainability.

The combination of high percentile ranking for T2022 and the complete absence of Medicare billing suggests the organization competes successfully within the Medicaid case-management market but has little to no footprint in Medicare. This profile is consistent with a specialist case-management agency whose market position is strong in-state but narrowly focused on Medicaid workstreams.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2022	Case management, per month	6,720	$310	$2M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wyoming Distribution

Quality Case Management Inc — 1 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wyoming

Full comparison — all codes billed, vs. Wyoming median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	7	140	1,170	$250	$471.9K

Nearby Providers

Other providers in the same ZIP code as Quality Case Management Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lincoln Self Reliance, Inc.	WY	Developmentally Disabled Services Day Training Agency	$0	$26.8M
North Lincoln County Hospital District	WY	Family Medicine Physician	$0	$541.9K
Cindy White	WY	Case Manager/Care Coordinator	$0	$508.3K
High Country Behavioral Health	WY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$317.6K
Jenning Voss	WY	Optometrist	$101.4K	$41.7K
Samuel Linford	WY	Orthopaedic Surgery Physician	$75.2K	$0
Chet Erickson	WY	Physical Therapist	$74.2K	$0
Myka Veigel	WY	Diagnostic Radiology Physician	$69K	$0
Jared Rose	WY	Physical Therapist	$58.7K	$0
Jeffrey Rosenberg	WY	Emergency Medicine Physician	$39K	$0

Quality Case Management Inc — Billing Profile & Reimbursement Data

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Quality Case Management 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

Nearby Providers

Frequently Asked Questions

References