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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Monarch (NPI 1518008861)

Field	Value
Entity Type	Organization
Organization	Monarch
Address	820 Grimes Blvd
City	Lexington
State	NC
ZIP	27292
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	February 9, 2007

Payer Source	Total Paid
Medicaid	$12.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0040	Assertive community treatment program, per diem	47,600	$210	$10M
H2022	Community-based wrap-around services, per diem	7,600	$250	$1.9M
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…	3,500	$80	$276.8K
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…	730	$110	$77K
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…	790	$70	$54.6K
H0038	Self‑help/peer services, per 15 minutes	470	$70	$31.1K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	130	$230	$29.5K
Q3014	Telehealth originating site facility fee	1,130	$20	$22.5K
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…	10	$140	$1.9K
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…	20	$50	$860

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Monarch — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0040	Assertive community treatment program, per diem	14	120	15,180	$230	$5M
H2022	Community-based wrap-around services, per diem	77	220	3,330	$290	$3.3M
H0038	Self‑help/peer services, per 15 minutes	257	310	2,820	$120	$1.3M
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…	371	1,710	810	$80	$274.5K
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…	2,387	4,400	960	$60	$271.3K
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…	1,940	4,130	670	$50	$219.9K
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…	567	620	210	$50	$63.1K
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…	155	170	100	$80	$57.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	309	870	70	$90	$28.9K
Q3014	Telehealth originating site facility fee	51	190	330	$20	$27.6K

Showing 1–10 of 11

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monarch	NC	Community/Behavioral Health Agency	$0	$19.9M
Monarch	NC	Community/Behavioral Health Agency	$0	$16.6M
Monarch	NC	Community/Behavioral Health Agency	$0	$14.9M
Monarch	NC	Community/Behavioral Health Agency	$0	$13.2M
Monarch	NC	Community/Behavioral Health Agency	$0	$12.5M
Monarch	NC	Case Management Agency	$0	$10.1M
Monarch	NC	Community/Behavioral Health Agency	$0	$9.6M
Alemu Mengistu	NC	Family Nurse Practitioner	$23K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lexington Medical Center	NC	General Acute Care Hospital	$0	$15.8M
Ot4 Kids, Inc	NC	Occupational Therapist	$0	$11.1M
County Of Davidson	NC	Land Ambulance	$866.3K	$3M
Sidney Ware	NC	Emergency Medicine Physician	$166.6K	$0
Terry Arnold	NC	Internal Medicine Physician	$136.3K	$0
Volker Stieber	NC	Radiation Oncology Physician	$119.4K	$0
Katie Twomley	NC	Cardiovascular Disease Physician	$80.2K	$0
William Richardson	NC	Nurse Practitioner	$48.8K	$0
Jung Kim-shapiro	NC	Anatomic Pathology & Clinical Pathology Physician	$41.6K	$0
Alexandre Caillat	NC	Urology Physician	$41.4K	$0

Monarch — Billing Profile & Reimbursement Data

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Monarch — 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