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

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

Marillac Clinic, Inc. (NPI 1518239219)

Field	Value
Entity Type	Organization
Organization	Marillac Clinic, Inc.
Address	526 29 1/2 Rd
City	Grand Junction
State	CO
ZIP	81504
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 27, 2012

Payer Source	Total Paid
Medicaid	$38.2M
Medicare	$0

Key Findings

This provider is effectively single-payer in the claims data: Medicare revenue is listed as none while total Medicaid revenue is $38.2M, indicating the organization's measurable billing activity is concentrated in Medicaid rather than Medicare. That payer concentration implies operational and revenue exposure tied closely to state Medicaid policy and reimbursement changes.

Medicaid revenue is highly concentrated among a very small set of codes — the precomputed top 3 Medicaid codes account for 73.0% of the provider's total Medicaid revenue. Those top three are D0999 ($14.8M, 39.6%), 99213 ($7.4M, 19.7%), and 99214 ($5.1M, 13.7%), so most dollars flow through an unlisted dental code and high-volume primary care evaluation-and-management visits.

D0999 is the single largest revenue driver at $14.8M (39.6% of Medicaid revenue) and is flagged as an extreme outlier in-state (ranks #3 of 149, 99th percentile). This suggests substantial dental or unlisted procedure volume relative to peers and that the provider is among the very highest statewide billers for that code.

The practice shows high-volume primary care E/M activity: 99213 ($7.4M, 19.7%) and 99214 ($5.1M, 13.7%) together form a major share of revenue and each ranks in the 99th percentile statewide. Those volumes imply a clinic model built around frequent established-patient office visits and mid-complexity outpatient management, consistent with primary care operations within an FQHC.

FQHC-specific and clinic-bundle activity is present but smaller in dollar share: T1015 (clinic visit/encounter) generated $3.3M (8.8%) and ranks #1 of 26 providers in-state (100th percentile), while G0467 (FQHC visit) appears at $167.6K (0.4%) and ranks #6 of 107 (95th percentile). This pattern indicates the organization uses both bundled clinic visit codes and traditional E/M billing; T1015 dominance suggests an operational emphasis on all-inclusive clinic encounters within Medicaid billing.

Behavioral health and preventive services are meaningful components of the mix: 90832 and 90834 psychotherapy codes, H0031 mental health assessment, and tobacco cessation codes 99406 and 1036F show notable volumes and above-typical ranks (for example, 99406 is $1.2M and ranks #2 of 91, 99th percentile). These entries point to integrated behavioral health and prevention services being delivered alongside primary medical and dental care.

Several dental codes beyond D0999 also register as extreme or notable outliers (D0145 $137.1K ranks #3 of 236, D0190 $113.4K ranks #3 of 165, and D1206 shows high volume), reinforcing that dental services are a distinct and high-volume service line for this provider within Medicaid. The combined presence of multiple dental codes at very high state percentiles suggests a sizable dental program embedded in the FQHC model.

The provider has an established operational tenure: NPI enumerated 2012-01-27 (~14 years ago), which indicates more than a decade of Medicaid-facing activity that produced the observed high-volume code mix. Given the lack of Medicare billing on file and the concentration of revenue in a few high-volume Medicaid codes, analysts should treat state Medicaid policy, coding mix, and dental/primary-care service lines as the primary drivers of this organization's revenue and competitive standing.

Medicaid: Complete Services Breakdown

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

106 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D0999	N/A	58,280	$250	$14.8M
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…	47,210	$160	$7.4M
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…	32,640	$160	$5.1M
T1015	Clinic visit/encounter, all-inclusive	41,650	$80	$3.3M
T1017	Targeted case management, each 15 minutes	7,510	$200	$1.5M
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	9,870	$120	$1.2M
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…	7,480	$150	$1.1M
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	18,990	$20	$379.7K
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…	2,940	$110	$335.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3,410	$80	$265.6K

Showing 1–10 of 106

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Marillac Clinic, Inc. — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

106 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	3	150	2,140	$260	$2M
H0039	Assertive community treatment, face-to-face, per 15 minutes	19	20	1,090	$160	$521.1K
T1017	Targeted case management, each 15 minutes	50	310	640	$80	$494.3K
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…	35	2,520	330	$100	$352K
D2150	Amalgam - two surfaces, primary or permanent	38	60	280	$110	$314.9K
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…	40	2,630	430	$90	$268.2K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	73	100	320	$80	$229.2K
T1015	Clinic visit/encounter, all-inclusive	1	30	180	$60	$213.5K
D2392	Post 2 surface resin‑based composite	340	690	290	$130	$148K
H0031	Mental health assessment, by non-physician	49	130	210	$140	$125K

Showing 1–10 of 106

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ariel Clinical Services	CO	Developmentally Disabled Services Day Training Agency	$0	$96.4M
Offender Services Inc	CO	Community/Behavioral Health Agency	$0	$13.2M
Metro Treatment Of Colorado LP	CO	Methadone Clinic	$88.5K	$8.2M
Foundations 4 Life, LLC	CO	Community/Behavioral Health Agency	$0	$5.4M
Offender Services, Inc	CO	Community/Behavioral Health Agency	$0	$3.7M
Dillon Companies LLC	CO	Community/Retail Pharmacy	$74.1K	$194.6K
Autumn Rowland	CO	Family Nurse Practitioner	$18.6K	$0

Marillac Clinic, Inc. — Billing Profile & Reimbursement Data

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Marillac Clinic, 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

Nearby Providers

Frequently Asked Questions

References