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

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

Midtown Health Center, Inc. (NPI 1487837696)

Key Findings

Field	Value
Entity Type	Organization
Organization	Midtown Health Center, Inc.
Address	302 W Phillip Ave
City	Norfolk
State	NE
ZIP	68701
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 11, 2007

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

MIDTOWN HEALTH CENTER, INC. is effectively a Medicaid-focused Federally Qualified Health Center: it has no Medicare billing on file and reports $10.1M in lifetime Medicaid revenue, indicating its billed activity and revenue base are concentrated in Medicaid programs rather than Medicare. The provider’s NPI was enumerated on 2007-12-11 (~19 years ago), showing long-standing enrollment which likely supports sustained Medicaid operations in its market.

Revenue concentration is highly skewed toward a small set of visit codes: the precomputed top-three Medicaid codes account for 85.8% of the provider’s total Medicaid revenue, signaling that a very small number of services generate the bulk of its Medicaid receipts. This concentration creates operational sensitivity to policy or reimbursement changes affecting those codes.

The dominant single code is T1015, which accounts for $5.5M (54.4% of Medicaid revenue) across 43.5K claims and is ranked #2 of 44 providers in-state (98th percentile). This pattern — heavy use of a clinic visit/encounter all-inclusive FQHC code — reinforces that Midtown operates with a high-volume, bundled primary-care or community health center model and is notably above typical state volume for this code.

99213 is the second major revenue driver at $2.4M (24.0% of Medicaid revenue) over 17.7K claims and ranks #27 of 696 providers in-state (96th percentile). The sizable volume of level-3 established outpatient E/M visits alongside T1015 suggests a mixed delivery of standard office-based E/M care in addition to federally qualified health center–style bundled visits.

99214 contributes $743.7K (7.4% of Medicaid revenue) from 5.6K claims and ranks #67 of 596 providers in-state (89th percentile), indicating a meaningful share of moderate-intensity established visits. Together with 99213 and 99214, the E/M mix points to a patient panel with regular chronic-care and more complex outpatient needs, supporting an FQHC service line that includes higher-intensity primary care visits.

Competitive standing in the state is strong specifically for the FQHC bundle: ranking #2 (98th percentile) on T1015 identifies Midtown as a leading FQHC biller in Nebraska for that code, while its high percentiles on common E/M codes (99213 at 96th percentile; 99214 at 89th percentile) mark it as a high-volume, above-typical provider but not an extreme outlier across all measures. For many ancillary codes (vaccines, preventive visits, behavioral health CPTs like 90834/90837), the provider sits in mid-to-high percentiles, reflecting a broad, multi-service primary care and behavioral health offering typical of FQHCs.

Service-line breadth includes preventive medicine (99391/99392/99393/99394 making up several smaller revenue lines), behavioral health (90834, 90837, 90832, 90791 collectively contributing notable claim volumes and revenue), and dental/ancillary services (D1206, D7140, D0150). These additional services, while individually smaller, indicate an integrated primary care model with pediatric preventive, immunizations (90670/90686), mental health, and dental components that support comprehensive Medicaid patient care.

Because Medicare activity is absent, the provider functions as effectively single-payer (Medicaid) from a revenue perspective. That payer concentration increases exposure to state Medicaid reimbursement policies and FQHC-specific rate changes; any shifts in Medicaid policy or audit focus on T1015 or bundled FQHC payments would disproportionately affect Midtown’s revenue.

The provider’s long tenure (NPI enumerated ~19 years ago) combined with concentrated high-volume billing for T1015 suggests established operational processes for delivering and billing bundled FQHC visits. Analysts should view Midtown as a mature, Medicaid-centric FQHC with dominant state-level presence on the FQHC clinic visit code and a complementary mix of primary care, behavioral health, preventive, and dental services.

Medicaid: Complete Services Breakdown

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	43,490	$130	$5.5M
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…	17,670	$140	$2.4M
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…	5,630	$130	$743.7K
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…	2,130	$150	$319.8K
90834	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…	3,070	$100	$300.4K
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…	1,220	$170	$201.3K
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…	1,520	$70	$100.4K
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…	840	$90	$73.4K
99203	The provider sees a new 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 provider…	370	$190	$69.2K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	1,380	$40	$53.6K

Showing 1–10 of 66

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Midtown Health Center, Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

66 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	2	40	1,930	$230	$2.3M
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…	27	700	660	$70	$305.1K
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…	67	600	610	$70	$251.4K
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…	16	70	360	$80	$234.7K
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…	19	70	230	$90	$222.7K
90834	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…	78	510	450	$100	$168.1K
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…	105	510	440	$140	$155.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	45	90	70	$200	$120.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	70	100	$100	$100.9K
D1351	Sealant - per tooth	79	130	460	$30	$84.7K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Faith Regional Health Services	NE	General Acute Care Hospital	$0	$7.3M
Faith Regional Physician Services, LLC	NE	Family Medicine Physician	$0	$5.5M
Behavioral Health Specialists Sunrise Place	NE	Substance Abuse Rehabilitation Facility	$0	$4.6M
Children & Adoleseant Clinic PC	NE	Pediatrics Physician	$0	$4.3M
The Well Ne	NE	Substance Abuse Rehabilitation Facility	$0	$3.1M
Nmg LLC	NE	Family Medicine Physician	$0	$2.9M
Cor Therapeutic Services, LLC	NE	Mental Health Counselor	$0	$2.2M
Rabih Fahed	NE	Hematology & Oncology Physician	$2M	$0
Oasis Counseling International	NE	Mental Health Counselor	$0	$2M
Liberty Centre Services, Inc.	NE	Case Manager/Care Coordinator	$0	$1.6M

Midtown Health Center, Inc. — Billing Profile & Reimbursement Data

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Midtown Health Center, 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midtown Health Center, Inc.	NE	Federally Qualified Health Center (FQHC)	$0	$196.3K
Midtown Health Center, Inc.	NE	Federally Qualified Health Center (FQHC)	$0	$192.3K
Carrie Fitzsimmons	WI	Family Nurse Practitioner	$123K	$0