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

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

Access Health Louisiana (NPI 1417999327)

Field	Value
Entity Type	Organization
Organization	Access Health Louisiana
Address	2900 Indiana Ave
City	Kenner
State	LA
ZIP	70065
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$32.1M
Medicare	$0

Key Findings

ACCESS HEALTH LOUISIANA reports $32.1M in lifetime Medicaid revenue and has no Medicare billing on file, making its commercial payer footprint effectively single-payer (Medicaid) in the available data. The provider's NPI was enumerated on 2006-06-12 (~20 years ago), indicating a long-tenured presence in the market.

Revenue concentration is extremely high: the precomputed top three Medicaid codes account for 99.9% of the provider's total Medicaid revenue, with T1015 alone representing $19.4M (60.5%) and H2020 representing $11.7M (36.4%). This indicates that the organization’s Medicaid revenue is dominated by a very small set of service lines rather than a broad mix of fee-for-service codes.

The code mix points to an FQHC operating model focused on high-volume clinic encounters and behavioral health services: T1015 (Clinic visit/encounter, all-inclusive) has 162.1K claims at $120 avg paid/claim ($19.4M revenue), and H2020 (Therapeutic behavioral services, per diem) has 148.1K claims at $79 avg paid/claim ($11.7M revenue). Together these two codes suggest integrated primary care and per-diem therapeutic behavioral services are the core service lines driving Medicaid revenue.

In-state competitive standing is dominant for the behavioral-service line: H2020 ranks #1 of 319 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), and T1015 ranks #5 of 806 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). These rankings indicate ACCESS HEALTH LOUISIANA is a major statewide provider for both all-inclusive clinic encounters and therapeutic behavioral services.

While the top two codes drive almost all dollars, ancillary codes and dental services appear as minor revenue contributors: D0999 accounts for $979.2K (3.0%) and other dental codes (for example D0330, D7140, D0150) each contribute only a few thousand dollars. These smaller revenue lines are typical and unremarkable in rank (e.g., D0999 ranks #25 of 166, 85th percentile), underscoring that clinical/delivery volume is overwhelmingly concentrated in the top ambulatory and behavioral categories.

Operationally, ACCESS HEALTH LOUISIANA shows very high claim volumes on many screening and assessment codes that report $0 revenue, which suggests substantial non-fee revenue activity tied to quality measurement, reporting, or bundled billing arrangements. Examples include 99213 (108.2K claims, $0 avg paid/claim), 96160 (98.6K claims, $0 avg paid/claim), and 96127 (76.9K claims, $0 avg paid/claim); several of these are listed as extreme outliers or notably above typical state volume, indicating heavy use of standardized assessments and screening documentation.

The provider’s payer mix and service concentration create both a strategic strength and risk: dominance in H2020 and T1015 positions the organization as a key behavioral and clinic services provider for Medicaid members in Louisiana, but reliance on the top three codes for 99.9% of Medicaid revenue exposes the organization to reimbursement or policy changes targeting these specific codes. Analysts should treat performance and contract negotiations with an understanding that small shifts in policy or per-diem/encounter rates for these codes could materially affect revenue.

Medicaid: Complete Services Breakdown

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

153 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	162,060	$120	$19.4M
H2020	Therapeutic behavioral services, per diem	148,100	$80	$11.7M
D0999	N/A	9,240	$110	$979.2K
D0330	N/A	820	$1	$3.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,250	$1	$2.5K
D0150	Comprehensive oral evaluation – new or established patient	1,000	$1	$2K
D0120	Periodic oral evaluation - established patient	1,750	$1	$1.8K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	570	$1	$1.7K
D0140	Limited oral evaluation – problem focused	1,650	$1	$1.6K
D0274	N/A	1,600	$1	$1.6K

Showing 1–10 of 153

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

Access Health Louisiana — 2 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

153 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	5	810	4,280	$110	$1.8M
H2020	Therapeutic behavioral services, per diem	1	320	2,270	$90	$637.8K
D0999	N/A	25	170	1,120	$90	$447K
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…	47	2,890	980	$40	$246.8K
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…	33	3,230	1,120	$30	$204.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	315	470	560	$40	$157.3K
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…	137	360	780	$50	$141.5K
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…	91	420	740	$50	$137.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	456	750	760	$30	$135.9K
D1120	Prophylaxis–child	287	610	750	$30	$125.3K

Showing 1–10 of 153

Related Providers

Other providers that share a Tax Identification Number (TIN) with Access Health Louisiana, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Access Health Louisiana	LA	Federally Qualified Health Center (FQHC)	$0	$15.2M
Access Health Louisiana	LA	Federally Qualified Health Center (FQHC)	$0	$9.2M
Access Health Louisiana	LA	Federally Qualified Health Center (FQHC)	$0	$7.5M
Access Health Louisiana	LA	Federally Qualified Health Center (FQHC)	$0	$4.7M
Benjamin Guidry	LA	Ophthalmology Physician	$412.7K	$81.3K
Keisha Harvey	LA	Family Medicine Physician	$38.1K	$264.1K
Joanna Holton	LA	Family Medicine Physician	$133.9K	$0
Jerry Stallings	LA	Family Nurse Practitioner	$107.1K	$0
Darria Bourgeois	LA	Psychiatric/Mental Health Nurse Practitioner	$69.4K	$0
Jillian Ashbolt	LA	Family Nurse Practitioner	$67.9K	$0

Nearby Providers

Other providers in the same ZIP code as Access Health Louisiana, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ochsner Medical Center - Kenner, L.L.C.	LA	General Acute Care Hospital	$0	$25.1M
Kenner Emergency Group LLC	LA	Emergency Medicine Physician	$0	$12M
Samuel Y Brown Md Apmc	LA	Pediatrics Physician	$0	$9.7M
Quynh Mai Clinic LLC	LA	Family Medicine Physician	$0	$7.2M
All America Personal Care, Inc.	LA	Developmentally Disabled Services Day Training Agency	$0	$6.8M
Nola Pediatrics	LA	Nursing Care Agency	$0	$6.1M
Mohammad Anwar	LA	Psychiatry Physician	$149.1K	$771.9K
Quynh Mai	LA	Family Medicine Physician	$272.5K	$4.5K
Samia Suleman	LA	Family Medicine Physician	$212.1K	$0
Seetha Muthavarapu	LA	Hospitalist Physician	$200.9K	$0

Access Health Louisiana — Billing Profile & Reimbursement Data

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Access Health Louisiana — 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