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

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

Adelante Healthcare, Inc. (NPI 1528126133)

Field	Value
Entity Type	Organization
Organization	Adelante Healthcare, Inc.
Address	3033 N Central Ave Ste 145
City	Phoenix
State	AZ
ZIP	85012
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 5, 2006

Payer Source	Total Paid
Medicaid	$245.5M
Medicare	$0

Key Findings

Revenue concentration is extreme: the precomputed top three Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T1015 alone representing $244.5M (99.6% of Medicaid revenue). This means nearly all billed Medicaid dollars flow through the all-inclusive clinic visit/encounter code rather than a diversified set of fee-for-service procedures.

The code mix and dominant revenue driver point to a classic FQHC operating model: T1015 (Clinic visit/encounter, all-inclusive) dominates revenue, indicating that Adelante Healthcare bills largely bundled, visit-based payments for primary care and comprehensive clinic encounters. Secondary procedure-level codes such as 59409 (obstetric delivery) and newborn codes (99460, 99463) are present but account for only a token share of revenue, suggesting some maternity/newborn services exist but are not major revenue centers.

This provider is effectively single‑payer in scale: there is no Medicare billing on file while Medicaid totals $245.5M, so operational and reimbursement risk are concentrated in Medicaid programs. Analysts should treat Adelante as a Medicaid-centric entity for contracting, utilization, and policy exposure assessments.

Competitive standing for the top revenue code is dominant in-state: T1015 ranks #3 of 357 providers in Arizona (99th percentile; labeled an extreme outlier), indicating far higher T1015 volume than typical peers. By contrast the companion codes have more modest statewide positions — T1016 ranks #193 of 1157 (83th percentile; typical, unremarkable) and 59409 ranks #4 of 20 (84th percentile; typical, unremarkable) — meaning the provider is a statewide leader for bundled clinic encounters but not necessarily for every specialty procedure.

Many high-volume CPT/HCPCS lines show very large claim counts with $0 or minimal avg paid values (examples include 99213, 99214, 90832, 90834, 90460 and 90686 all reported with large claim counts and $0 avg paid/claim). Several of these codes are ranked at or near the 100th percentile in-state and are labeled as "extreme outlier" or "notably above typical state volume," which suggests encounter-level or ancillary service activity is being captured at high frequency while payments are either bundled into T1015 or reimbursed under alternative arrangements. This pattern is consistent with FQHC billing where many services appear as claims but the primary revenue recognition is through the all-inclusive visit code.

There are statistically notable outliers beyond T1015 that warrant attention: 0012A appears as 1.9K claims at $1 avg and ranks #10 of 204 providers (96th percentile; extreme outlier), and several psychotherapy and vaccine codes (e.g., 90832, 90834, 90686) rank at the top of statewide lists (some at 100th or 99th percentile). While these items have minimal direct revenue impact in the dataset (many reported with $0 revenue), their high-volume reporting may indicate large programmatic activity (behavioral health, immunization campaigns, or reporting/bundling practices) that is operationally significant even if not separately paid.

The NPI tenure shows long-standing presence: the NPI was enumerated 2006-12-05 (~20 years ago), supporting that Adelante Healthcare is an established FQHC in Phoenix. Combined with the concentrated Medicaid billing profile and the statewide high-volume ranks for encounter and ancillary codes, the data portray a mature safety-net provider with a large Medicaid patient panel and a billing footprint centered on bundled clinic encounters.

Medicaid: Complete Services Breakdown

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

174 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	902,240	$270	$244.5M
T1016	Case management, each 15 minutes	33,070	$20	$793.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	200	$800	$158.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	470	$60	$28K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	480	$60	$27.1K
H0038	Self‑help/peer services, per 15 minutes	2,170	$10	$17.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	1,190	$1	$4.8K
99463	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center, through the time of discharge, or release, from the…	30	$80	$2.4K
0012A	N/A	1,890	$1	$1.9K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	460	$1	$920

Showing 1–10 of 174

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Adelante Healthcare, Inc. — 2 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

174 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	360	3,640	$230	$7.7M
T1016	Case management, each 15 minutes	193	1,160	2,110	$30	$1.2M
H0004	Behavioral health counseling and therapy, per 15 minutes	304	1,150	1,700	$90	$1M
H0038	Self‑help/peer services, per 15 minutes	230	580	1,250	$80	$479.7K
H0031	Mental health assessment, by non-physician	333	810	280	$120	$360.5K
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…	11	3,040	750	$50	$343.9K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	4	20	60	$890	$339.2K
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…	5	2,780	600	$50	$267K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	9	40	390	$140	$264.4K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	48	110	440	$90	$208.3K

Showing 1–10 of 174

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Canyonlands Community Health Care	AZ	Family Medicine Physician	$0	$31.3M
Lorianne Gillis	MA	Family Nurse Practitioner	$90.6K	$0
Narinder Brar	AZ	Obstetrics & Gynecology Physician	$88K	$1.5K
Kathleen Hogarty	AZ	Psychiatric/Mental Health Nurse Practitioner	$36.5K	$0
Kavir Saxena	NE	Psychiatry Physician	$30.9K	$0
Brian Mccarthy	OR	Psychiatric/Mental Health Nurse Practitioner	$16.1K	$0
Janeen Bjork	AZ	Family Medicine Physician	$8.9K	$0
Raymond Holsten	AZ	Family Medicine Physician	$2.4K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Park Health Center	AZ	Federally Qualified Health Center (FQHC)	$0	$351.5M
The Tungland Company, LLC	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$332M
Banner-university Medical Group	AZ	Multi-Specialty Clinic/Center	$0	$133.7M
Prileo Healthcare LLC Dba Prileo Home Care	AZ	In Home Supportive Care Agency	$0	$88.8M
Denova Collaborative Health, LLC	AZ	Multi-Specialty Clinic/Center	$0	$87.9M
Southwest Behavioral Health Services Inc	AZ	Community/Behavioral Health Agency	$0	$83.5M
Terros, Inc.	AZ	Community/Behavioral Health Agency	$0	$81.7M
Accentcare At Home, Inc.	AZ	In Home Supportive Care Agency	$0	$65.7M
Banner Physician Super Specialists Arizona LLC	AZ	Multi-Specialty Clinic/Center	$0	$36.9M
Banner - University Hospital Based Physicians LLC	AZ	General Acute Care Hospital	$0	$29.7M

Adelante Healthcare, Inc. — Billing Profile & Reimbursement Data

Sign up for Adelante Healthcare, Inc. — Billing Profile & Reimbursement Data policy alerts

Adelante Healthcare, Inc. — Billing Profile & Reimbursement Data

Sign up for Adelante Healthcare, Inc. — Billing Profile & Reimbursement Data policy alerts

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