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

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

Southcentral Foundation (NPI 1386680056)

Key Findings

Field	Value
Entity Type	Organization
Organization	Southcentral Foundation
Address	1001 S Knik Goose Bay Rd
City	Wasilla
State	AK
ZIP	99654
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$30.7M
Medicare	$0

SOUTHCENTRAL FOUNDATION reports no Medicare billing on file and $30.7M in lifetime Medicaid revenue, so the organization’s public payment profile is effectively single‑payer Medicaid in the available data. Analysts should treat comparisons and risk assessments accordingly, because there is no Medicare data to contextualize scale or service mix across both programs.

Revenue is highly concentrated: the top three Medicaid codes (99213, 92014, 99214) together account for 85.3% of this provider’s total Medicaid revenue. That concentration indicates financial reliance on a small set of outpatient evaluation/management and ophthalmology services rather than a broadly diversified Medicaid billing base.

99213 is the dominant revenue driver with 37.4K claims, $570 avg paid/claim, and $21.3M revenue (69.6% of Medicaid revenue); the code ranks #10 of 485 providers in-state (98th percentile) and is described as notably above typical state volume. This combination of very high claim volume and above‑average payment per visit signals a large ambulatory primary care or established patient clinic footprint focused on routine follow‑up visits.

92014 (4.9K claims, $585 avg paid/claim, $2.8M revenue; 9.3% of Medicaid revenue) ranks #6 of 102 in-state (95th percentile) and is also described as notably above typical state volume, indicating a strong ophthalmology/comprehensive eye exam service line. The presence of both 92014 and 92004 among the top billers suggests the organization operates substantial new and established eye-care visits alongside its general outpatient practice.

99214 (3.9K claims, $506 avg paid/claim, $2M revenue; 6.4% of Medicaid revenue) ranks #71 of 440 (84th percentile) and is labeled typical/unremarkable for the state. Its placement shows the provider delivers moderate‑complexity established outpatient visits at scale but without the same outlier status as 99213.

Beyond the top three codes, the profile includes ancillary ambulatory services — for example, physical therapy (97110: 1.2K claims, $574 avg, $701.4K), immunizations (90471: 1.9K claims, $239 avg, $463.2K), and high-volume low‑unit vision screening (92015: 8K claims, $24 avg, $191.3K). These secondary lines together represent modest revenue contributions but indicate multi‑specialty clinic operations that bundle primary care, eye care, rehabilitation, imaging, and preventive services.

The NPI was enumerated on 2006-06-21 (~20 years ago), so this is an established provider with long tenure in the state Medicaid market. Combined with the high percentile rankings for key codes (especially 99213 and 92014), the evidence points to a mature, sizable ambulatory provider that is a major Medicaid player in its service areas but remains dependent on a narrow set of outpatient visit codes for most of its reported Medicaid revenue.

Medicaid: Complete Services Breakdown

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

48 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…	37,360	$570	$21.3M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	4,860	$590	$2.8M
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…	3,890	$510	$2M
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	1,910	$620	$1.2M
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…	1,220	$570	$701.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,940	$240	$463.2K
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,…	800	$550	$439.9K
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.	760	$480	$365.9K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	900	$250	$221.2K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	7,970	$20	$191.3K

Showing 1–10 of 48

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Southcentral Foundation — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	75	100	360	$340	$1.2M
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…	10	490	680	$260	$1M
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.	64	120	970	$140	$652.1K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	66	70	2,310	$100	$531.8K
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…	71	440	580	$170	$458.7K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	26	50	900	$80	$318.1K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	6	100	460	$250	$317.6K
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…	50	120	720	$110	$300.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	15	100	350	$260	$254.6K
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…	48	100	330	$170	$226.4K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mat-su Services For Children & Adults	AK	Developmentally Disabled Services Day Training Agency	$0	$34.2M
Mat - Su Health Services Inc.	AK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$24.4M
Set Free Alaska, Inc.	AK	Substance Abuse Rehabilitation Facility	$0	$21.5M
Hope Community Resources Inc	AK	Respite Care	$0	$19.3M
Community Medical Services Montana Private LLC	AK	Methadone Clinic	$395.9K	$18.9M
Alaska Home Care	AK	Home Health Agency	$0	$14.1M
True North Recovery Inc	AK	Community/Behavioral Health Agency	$0	$11.5M
Pediatric Dentistry Of Alaska	AK	Dental Clinic/Center	$0	$11.4M
Backcountry Therapeutics LLC	AK	Occupational Therapist	$0	$11M
True North Recovery Inc	AK	Community/Behavioral Health Agency	$0	$10.4M

Southcentral Foundation — Billing Profile & Reimbursement Data

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Southcentral Foundation — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$20.3M
Southcentral Foundation	AK	Rehabilitation Clinic/Center	$0	$17M
Southcentral Foundation	AK	Multi-Specialty Clinic/Center	$0	$15M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$13.4M
Southcentral Foundation	AK	Mental Illness Community Based Residential Treatment Facility	$0	$13.3M
Southcentral Foundation	AK	Primary Care Clinic/Center	$0	$12.5M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$12.1M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$11.1M
Southcentral Foundation	AK	Multi-Specialty Clinic/Center	$0	$11M
Southcentral Foundation	AK	Community/Behavioral Health Agency	$0	$10.2M