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    OpenPayerNPI Medicare & MedicaidLake Superior Community Health Center
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    Lake Superior Community Health Center — Billing Profile & Reimbursement Data

    NPI 1578781639 · Superior, WI · Federally Qualified Health Center (FQHC)

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    Lake Superior Community Health Center is a federally qualified health center (fqhc) provider located in Superior, Wisconsin. This profile covers 0 Medicare and 47 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationLake Superior Community Health Center
    Address3600 Tower Avenue
    CitySuperior
    StateWI
    ZIP54880
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedApril 23, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    47 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive20,210$210$4.2M
    90834In 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…8,610$30$223.8K
    99213The 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…6,220$20$143.1K
    99214The 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…2,720$30$73.5K
    G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…1,790$30$48.2K
    90832In 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…1,670$20$35K
    H0022Alcohol and/or drug intervention service (planned facilitation)2,710$10$21.7K
    G0470Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…550$30$15.3K
    80047The lab analyst performs a basic metabolic panel (BMP) test in which he measures the blood level of eight chemicals identified in the descriptor including ionized calcium, sodium, potassium,…1,380$10$11.1K
    D0140Limited oral evaluation – problem focused3,660$1$11K

    Showing 1–10 of 47

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Wisconsin median

    47 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive14604,880$230$4.9M
    99214The 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…3131,630270$40$205.3K
    99213The 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…2031,760250$40$173.2K
    H0022Alcohol and/or drug intervention service (planned facilitation)37190400$30$140.3K
    D2392Post 2 surface resin‑based composite71270510$60$123.3K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)82220430$50$111.4K
    90834In 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…66790400$40$109.6K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…2243003,190$10$91.3K
    99212The 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,…450690160$60$90.4K
    D1351Sealant - per tooth2103401,020$20$90.2K

    Showing 1–10 of 47

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Lake Superior Community Health Center, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lake Superior Community Health CenterMNFederally Qualified Health Center (FQHC)$0$13.7M
    Lake Superior Community Health CenterWIFederally Qualified Health Center (FQHC)$0$4.2M
    Emily AndersonWIFamily Medicine Physician$3.4K$0
    Adam WennerstenWIPhysician Assistant$3.3K$0
    Jacob OestreichMNFamily Medicine Physician$2.3K$0
    Nicole ShockleyMNNurse Practitioner$2K$0

    Nearby Providers

    Other providers in the same ZIP code as Lake Superior Community Health Center, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St. Mary's Hospital Of SuperiorWICritical Access Hospital$0$13.4M
    Elisha ZavodnikWIBehavior Analyst$0$4.1M
    Brightwater Health Dba Human Development CenterWICommunity/Behavioral Health Agency$0$3.4M
    Douglas CountyWIPublic Health or Welfare Agency$0$2.6M
    St. Mary's Hospital Of SuperiorWICritical Access Hospital Clinic/Center$0$1.6M
    The Creative Counseling GroupWIMental Health Counselor$0$1.2M
    Walgreen CoWIPharmacy$245.3K$54.3K
    John YoonWIOphthalmology Physician$153.8K$0
    Anna GreinerWIPhysician Assistant$29.2K$0
    Professional Portable Radiologic Services, Inc.WIPortable X-ray and/or Other Portable Diagnostic Imaging Supplier$17.8K$3K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Wisconsin Providers
    3 of 5 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Wisconsin Distribution
    Lake Superior Community Health Center — 0 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Wisconsin