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

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

Spiral Health Systems Inc. (NPI 1528629680)

Field	Value
Entity Type	Organization
Organization	Spiral Health Systems Inc.
Address	11410 Oak St
City	Kansas City
State	MO
ZIP	64114
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	June 27, 2019

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	63,410	$80	$4.9M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Spiral Health Systems Inc. — 0 of 1 code billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	222	1,330	6,550	$80	$4.6M

Nearby Providers

Other providers in the same ZIP code as Spiral Health Systems Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cornerstones Of Care	MO	Mental Illness Community Based Residential Treatment Facility	$0	$7M
Sherwood Center For The Exceptional Child	MO	Developmentally Disabled Services Day Training Agency	$0	$6.3M
Prime Healthcare Services - Kansas City, LLC	MO	General Acute Care Hospital	$0	$4.4M
Mark Box	MO	Rheumatology Physician	$1.3M	$0
John Rupp	MO	Dermatology Physician	$747.1K	$0
John Armilio	MO	Family Medicine Physician	$632.3K	$0
Ramilo Gatapia	MO	Internal Medicine Physician	$213.8K	$401.5K
Thad Stephens	MO	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$309K	$0
Patrick Perkins	MO	Pulmonary Disease Physician	$281.1K	$0
William White	MO	Ophthalmology Physician	$262.4K	$0

Spiral Health Systems Inc. — Billing Profile & Reimbursement Data

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Spiral Health Systems 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

Nearby Providers

Frequently Asked Questions

References