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

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

Abc Counseling & Family Services Inc (NPI 1437217114)

Field	Value
Entity Type	Organization
Organization	Abc Counseling & Family Services Inc
Address	705 E Lincoln
City	Normal
State	IL
ZIP	61761
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	December 5, 2006

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	24,870	$90	$2.3M
H2000	Comprehensive multidisciplinary evaluation	5,300	$90	$493.1K
T1016	Case management, each 15 minutes	630	$40	$25.7K
H0031	Mental health assessment, by non-physician	110	$70	$7.3K
H0032	Mental health service plan development by non-physician	60	$40	$2.3K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	70	$20	$1.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Abc Counseling & Family Services Inc — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	86	800	2,480	$90	$962.2K
H2000	Comprehensive multidisciplinary evaluation	119	420	1,450	$100	$631.8K
T1016	Case management, each 15 minutes	304	470	1,830	$60	$475.9K
H0031	Mental health assessment, by non-physician	146	220	190	$90	$33.7K
H0032	Mental health service plan development by non-physician	175	220	190	$60	$20.2K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	982	1,410	210	$10	$9.4K

Nearby Providers

Other providers in the same ZIP code as Abc Counseling & Family Services Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pramern Sriratana	IL	Hematology & Oncology Physician	$1.9M	$514K
Dana Altenburger	IL	Anatomic Pathology & Clinical Pathology Physician	$44.2K	$2M
Thomas Pliura	IL	Emergency Medical Services (Emergency Medicine) Physician	$31.5K	$1.6M
Mumtaz Siddiqui	IL	Cardiovascular Disease Physician	$371K	$1.2M
Hwan Jeong	IL	Hematology & Oncology Physician	$658.1K	$189.7K
Gastrointestinal Institute, LLC.	IL	Ambulatory Surgical Clinic/Center	$785.3K	$2.7K
Sumit Bhatia	IL	Retina Specialist (Ophthalmology) Physician	$644.4K	$6.1K
Stephen Matter	IL	Gastroenterology Physician	$217K	$355.1K
Naveed Yousuf	IL	Neuroradiology Physician	$208.7K	$230.4K
Pooria Javadi	IL	Diagnostic Radiology Physician	$114.7K	$269K

Abc Counseling & Family Services Inc — Billing Profile & Reimbursement Data

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Abc Counseling & Family Services 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

Nearby Providers

Frequently Asked Questions

References