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

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

Healthpoint Family Care Inc (NPI 1508889742)

Field	Value
Entity Type	Organization
Organization	Healthpoint Family Care Inc
Address	215 E 11th St
City	Newport
State	KY
ZIP	41071
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 26, 2006

Payer Source	Total Paid
Medicaid	$29.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

136 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…	295,490	$30	$9.5M
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…	44,450	$50	$2.2M
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,…	80,080	$30	$2M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	35,300	$40	$1.3M
D0330	N/A	30,780	$40	$1.2M
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…	16,400	$70	$1.2M
D0150	Comprehensive oral evaluation – new or established patient	42,750	$30	$1.1M
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…	14,250	$60	$897.4K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	19,910	$40	$875.9K
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…	15,390	$50	$769.6K

Showing 1–10 of 136

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Healthpoint Family Care Inc — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

136 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	880	1,270	760	$80	$447.2K
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…	11	3,340	1,020	$30	$296K
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…	43	2,460	580	$40	$245K
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…	124	600	600	$40	$207.8K
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…	8	230	720	$60	$180.1K
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…	7	260	540	$70	$176.6K
T1015	Clinic visit/encounter, all-inclusive	4	60	280	$40	$163.9K
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…	175	230	350	$100	$162.2K
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…	15	500	250	$60	$152.8K
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…	31	40	6,320	$10	$131.4K

Showing 1–10 of 136

Related Providers

Other providers that share a Tax Identification Number (TIN) with Healthpoint Family Care Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laura Faughn	KY	Family Medicine Physician	$109K	$0
Eleida Tur Oliva	KY	Family Medicine Physician	$103.4K	$0
Starla Sparks	OH	Family Nurse Practitioner	$38.3K	$0

Nearby Providers

Other providers in the same ZIP code as Healthpoint Family Care Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ethos Holding Corp	KY	Clinical Medical Laboratory	$17.8M	$28.5M
Michael Wehmann	KY	Ophthalmology Physician	$171.2K	$0
Robert Toltzis	KY	Cardiovascular Disease Physician	$138.9K	$0
Darek Sanford	KY	Cardiovascular Disease Physician	$116.2K	$0
Elizabeth Czirr	KY	Optometrist	$51.1K	$8.9K
Richard Abrahamson	KY	Ophthalmology Physician	$52K	$0
Michelle Garrison	KY	Physician Assistant	$33.1K	$0
Elaine Shields	KY	Registered Nurse	$32.8K	$0
Kristin Legrand	KY	Nurse Practitioner	$22.4K	$0

Healthpoint Family Care Inc — Billing Profile & Reimbursement Data

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Healthpoint Family Care 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

Related Providers

Nearby Providers

Frequently Asked Questions

References