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

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

Family Health Center Of Marshfield Inc (NPI 1437264140)

Field	Value
Entity Type	Organization
Organization	Family Health Center Of Marshfield Inc
Address	1307 N Saint Joseph Ave
City	Marshfield
State	WI
ZIP	54449
Taxonomy	Dental Clinic/Center
NPI Enumerated	August 20, 2006

Payer Source	Total Paid
Medicaid	$20.4M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-centric dental provider: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $20.4M, indicating the practice operates almost entirely within the Medicaid payer stream rather than a mixed Medicare/Medicaid model. The NPI was enumerated on 2006-08-20 (~20 years ago), consistent with long-standing operation in the state dental safety-net.

Revenue is highly concentrated in a small set of dental services: the precomputed top 3 Medicaid codes by revenue account for 36.2% of this provider's total Medicaid revenue. Those top codes (D2392, D7140, D1110) are primarily restorative and basic operative/dental hygiene services, showing the clinic’s revenue base is driven by routine restorative work, extractions, and adult prophylaxis.

The provider is a statewide volume leader on multiple high-frequency dental codes: D2392 ($2.5M revenue), D7140 ($2.4M revenue), and D1110 ($2.3M revenue) each rank #1 in-state and are described as extreme outliers, far above typical state volume for those codes. Numerous other high-volume codes (D1206 130.5K claims, D0120 103.1K claims, D0150 34.2K claims, D0210 38.6K claims) also rank at the 100th percentile in-state, reinforcing that the clinic captures unusually large Medicaid share for common preventive and restorative procedures.

The mix of codes and claim volumes points to a high-throughput general dentistry operation focused on prevention and routine restorative care: very large counts for D1206 (130.5K claims, $1.7M revenue), D0120 (103.1K claims, $1.4M revenue), and D0140 (56.5K claims, $1.1M revenue) indicate extensive prophylaxis, fluoride, and evaluation services, while D2392 and D2391 show substantial restorative composite work. This pattern suggests the clinic emphasizes volume-based preventive and basic restorative visits rather than a specialty surgical or endodontic case mix.

While dominant in many routine codes, the provider shows more modest engagement in higher-complexity or specialty procedures: D2930 ($426.8K revenue) and D7210 ($242.7K revenue) rank in the 78th and 84th percentiles respectively and are labeled typical or unremarkable, indicating the clinic does not mirror its dominance in routine codes for more complex surgical services. Similarly, extractions requiring bone removal (D7210) and certain crown/operative entries appear at ordinary state volumes rather than as extreme outliers.

There is a small but nontrivial presence of general medical E/M billing under Medicaid: 99214 ($145.4K, 0.7% of Medicaid revenue) and 99213 ($94.7K, 0.5% of Medicaid revenue) appear in the top-25 Medicaid list at typical state percentiles. These E/M entries represent a minor share of revenue and suggest occasional medical evaluation encounters are billed through the same NPI, but they do not materially shift the clinic’s role as a dental-focused Medicaid provider.

Competitive positioning in-state is emphatically dominant for core dental services: many of the provider’s highest-revenue codes are ranked #1 of hundreds of providers in Wisconsin and labeled extreme outliers, which implies this clinic is a major statewide dental care hub for Medicaid enrollees for those procedures. Analysts evaluating network capacity, access to routine dental care for Medicaid members, or provider consolidation should treat this site as a high-capacity dental node given the repeated 100th-percentile rankings.

Operational risk and business implications follow from the concentrated Medicaid dependency and code mix: reliance on large Medicaid volumes for a narrow set of high-frequency preventive and restorative codes could make revenue sensitive to state Medicaid reimbursement policy changes or utilization management for those specific CDT codes. Given the long tenure (NPI since 2006-08-20 (~20 years ago)) and entrenched high volumes, any payer contract or policy shift that affects D2392, D7140, or D1110 will disproportionately affect this provider’s Medicaid revenue base.

Medicaid: Complete Services Breakdown

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

59 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	45,810	$50	$2.5M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	57,130	$40	$2.4M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	86,000	$30	$2.3M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	130,540	$10	$1.7M
D0210	Intraoral - complete series of radiographic images	38,570	$40	$1.7M
D0120	Periodic oral evaluation - established patient	103,130	$10	$1.4M
D0140	Limited oral evaluation – problem focused	56,460	$20	$1.1M
D1120	Prophylaxis–child	44,290	$20	$930.2K
D0274	N/A	54,380	$20	$924.4K
D2391	Resin‑based composite – one surface, posterior	18,970	$40	$796.7K

Showing 1–10 of 59

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Family Health Center Of Marshfield Inc — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D2930	N/A	17	80	410	$150	$427.7K
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…	272	1,630	270	$40	$205.3K
D7240	N/A	6	20	130	$220	$203.5K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	21	120	490	$100	$179.5K
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…	285	1,760	250	$40	$173.2K
D7230	N/A	6	30	110	$180	$163.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	336	350	300	$50	$157.9K
H0022	Alcohol and/or drug intervention service (planned facilitation)	24	190	400	$30	$140.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	816	900	410	$70	$130.4K
D2392	Post 2 surface resin‑based composite	1	270	510	$60	$123.3K

Showing 1–10 of 59

Related Providers

Other providers that share a Tax Identification Number (TIN) with Family Health Center Of Marshfield Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mchs Hospitals Inc	WI	Rural Acute Care Hospital	$0	$45.3M
Marshfield Clinic Inc	WI	Clinic/Center	$526.8K	$19.6M
Mchs Hospitals Inc	WI	General Acute Care Hospital	$0	$12.4M
Mchs Hospitals Inc	WI	Clinic/Center	$0	$11.8M
Lakeview Medical Center Inc Of Rice Lake	WI	Rural Acute Care Hospital	$0	$10M
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$8.7M
Flambeau Hospital Inc	WI	Critical Access Hospital	$0	$7M
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$5.8M
Mchs Hospitals Inc	WI	Clinic/Center	$0	$4.1M
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$3.8M

Nearby Providers

Other providers in the same ZIP code as Family Health Center Of Marshfield Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$3.4M
Family Health Center Of Marshfield Inc	WI	Federally Qualified Health Center (FQHC)	$0	$3.2M
Marriage & Family Health Services, Ltd.	WI	Adolescent and Children Mental Health Clinic/Center	$0	$2.6M
Mchs Hospitals Inc	WI	Land Ambulance	$1.4M	$987.9K
School District Of Marshfield	WI	Local Education Agency (LEA)	$0	$1.7M
Total Renal Care Inc	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
City Of Marshfield	WI	Land Ambulance	$200K	$484.6K
Lori Bents	WI	Chiropractor	$27.4K	$399.4K
Yan Guo	WI	Ophthalmology Physician	$318.7K	$0
Yi Hsieh	WI	Urology Physician	$299K	$0

Family Health Center Of Marshfield Inc — Billing Profile & Reimbursement Data

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Family Health Center Of Marshfield 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

Related Providers

Nearby Providers

Frequently Asked Questions

References