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

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

Southcentral Foundation (NPI 1538378625)

Field	Value
Entity Type	Organization
Organization	Southcentral Foundation
Address	4320 Diplomacy Dr
City	Anchorage
State	AK
ZIP	99508
Taxonomy	Community Health Clinic/Center
NPI Enumerated	May 22, 2007

Payer Source	Total Paid
Medicaid	$130.3M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: Total Medicare revenue: none (no Medicare billing on file) while Total Medicaid revenue: $130.3M, so publicly reimbursed activity for this entity is concentrated in Medicaid rather than Medicare. The absence of Medicare billing on file indicates payer exposure and reimbursement strategy should be evaluated primarily through the Medicaid lens.

Revenue concentration is extreme: the precomputed top 3 Medicaid codes by revenue account for 94.2% of this provider's total Medicaid revenue, driven almost entirely by routine outpatient evaluation-and-management and a single therapy code. That concentration implies most Medicaid dollars flow through a very small set of service lines, leaving overall revenue sensitive to policy, coding, or utilization changes affecting those codes.

The practice’s billing mix and code descriptions point to a primary-care–centered model with ancillary therapy capacity. The top two codes are 99213 ($99.6M revenue) and 99214 ($20.5M revenue), both established-patient office visits, and the third is 97110 ($2.7M revenue) for therapeutic exercise, indicating core delivery of high-volume outpatient primary care complemented by physical therapy services.

Competitive standing in-state for core E&M is dominant: for 99213 this provider ranks #2 of 485 providers in-state (100th percentile; extreme outlier), and for 99214 it ranks #7 of 440 providers in-state (99th percentile; extreme outlier). Those rank/percentile labels signal this entity is a major statewide player for routine established-patient visits and operates at volumes far above typical peers for those codes.

Other code-level signals show service breadth beyond adult primary care into pediatrics and telemedicine: notable volumes for pediatric well visits (99393, 99392, 99394, 99391) and multiple telephone/telehealth codes (99441, 99442, 99443) appear in the top-25 list. Several of those codes rank in high state percentiles (for example, 99441 ranks #2 of 41, 94th percentile; 99393 ranks #4 of 43, 93rd percentile), suggesting substantive pediatric preventive and remote-visit activity alongside adult primary care.

Payment-per-claim patterns for the largest codes are consistent with outpatient primary-care reimbursement in this dataset: 99213 shows $687 avg paid/claim and 99214 $677 avg paid/claim, while 97110 shows $679 avg paid/claim. The similarity of avg paid/claim across these high-volume codes underscores that high revenue is driven more by extraordinary visit volume than by outsized per-claim reimbursement.

While dominant on key codes, the provider’s broader service lines are more typical relative to peers: rehabilitation codes such as 97110 (rank #23 of 116, 81th percentile) and other PT/CPT codes appear at moderate-to-typical state percentiles, and several preventive/child codes are notably above typical but not extreme outliers. This pattern indicates strong primary-care market share combined with reasonably scaled ancillary and pediatric preventive services rather than an unusually broad specialty footprint.

The organization has a long-standing Medicare/Medicaid presence, with NPI enumerated on 2007-05-22 (~19 years ago), which supports interpreting these high volumes as the result of sustained operations. Given the concentration in a few Medicaid E&M codes and long tenure, analysts should consider how changes in state Medicaid policy, visit modality (telehealth), or outpatient reimbursement could materially affect the provider’s revenue profile.

Medicaid: Complete Services Breakdown

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

28 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…	144,970	$690	$99.6M
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…	30,250	$680	$20.5M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3,990	$680	$2.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,970	$670	$1.3M
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,…	1,940	$660	$1.3M
99442	N/A	2,040	$590	$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…	1,350	$670	$906.5K
99441	N/A	1,450	$620	$898.2K
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…	660	$810	$535.2K
99443	N/A	690	$590	$405.1K

Showing 1–10 of 28

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

Southcentral Foundation — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

28 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	2	490	680	$260	$1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	101	120	970	$140	$652.1K
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…	7	440	580	$170	$458.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	23	120	720	$110	$300.2K
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…	100	100	330	$170	$226.4K
99442	N/A	4	50	100	$440	$202.8K
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…	11	30	330	$200	$189K
99443	N/A	6	40	50	$390	$171.3K
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,…	20	210	160	$230	$148.2K
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…	8	50	100	$220	$134.3K

Showing 1–10 of 28

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alaska Native Tribal Health Consortium	AK	General Acute Care Hospital	$0	$397.1M
Providence Health & Services Washington	AK	General Acute Care Hospital	$0	$161.5M
Alaska Native Tribal Health Consortium	AK	Transportation Broker	$0	$65.5M
The Arc Of Anchorage	AK	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$50.8M
Good Samaritan Care Services	AK	In Home Supportive Care Agency	$0	$46.1M
Alaska Native Tribal Health Consortium	AK	General Acute Care Hospital	$0	$33.1M
Galen Hospital Alaska, Inc.	AK	General Acute Care Hospital	$0	$31.8M
Anchorage Community Mental Health	AK	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$31.7M
Patient Housing At Anmc	AK	General Acute Care Hospital	$0	$31M
Alaska Emergency Medicine Associates	AK	Emergency Medicine Physician	$0	$28.1M

Southcentral Foundation — Billing Profile & Reimbursement Data

Sign up for Southcentral Foundation — Billing Profile & Reimbursement Data policy alerts

Southcentral Foundation — Billing Profile & Reimbursement Data

Sign up for Southcentral Foundation — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References