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

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

Ahora Y Siempre Inc (NPI 1598084774)

Field	Value
Entity Type	Organization
Organization	Ahora Y Siempre Inc
Address	800 Ross Ave Apt 4114
City	Dallas
State	TX
ZIP	75202
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	May 26, 2010

Payer Source	Total Paid
Medicaid	$35.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	75,890	$230	$17.2M
T2016	Habilitation, residential, waiver; per diem	35,640	$120	$4.3M
M0123	N/A	35,540	$80	$2.7M
M0124	N/A	13,410	$120	$1.6M
M0125	N/A	15,620	$90	$1.5M
H2014	Skills training and development, per 15 minutes	29,520	$50	$1.3M
M0354	N/A	10,030	$130	$1.3M
M0360	N/A	8,490	$110	$934.3K
T2020	Day habilitation, waiver; per diem	21,700	$40	$802.9K
M0122	N/A	10,570	$70	$771.6K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Texas Distribution

Ahora Y Siempre Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Texas

Full comparison — all codes billed, vs. Texas median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	12	110	6,810	$200	$8.1M
H2016	Comprehensive community support services, per diem	26	430	5,020	$270	$5.6M
H2014	Skills training and development, per 15 minutes	94	560	9,630	$80	$1.4M
B4149	Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral…	29	30	1,100	$360	$977.3K
M0124	N/A	3	30	5,900	$120	$879.4K
M0123	N/A	6	190	7,520	$80	$861.3K
M0125	N/A	6	70	6,600	$90	$810.4K
M0122	N/A	26	120	6,320	$70	$648K
M0360	N/A	9	50	3,760	$80	$459.5K
M0354	N/A	4	40	3,630	$100	$459.4K

Showing 1–10 of 36

Ahora Y Siempre Inc — Billing Profile & Reimbursement Data

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Ahora Y Siempre 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

Frequently Asked Questions

References