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

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

Greater Philadelphia Health Action Inc. (NPI 1609321041)

Field	Value
Entity Type	Organization
Organization	Greater Philadelphia Health Action Inc.
Address	1401 S. 31st Street
City	Philadelphia
State	PA
ZIP	19146
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 15, 2016

Payer Source	Total Paid
Medicaid	$22M
Medicare	$0

Medicaid: Complete Services Breakdown

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

109 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	112,750	$190	$21.9M
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	2,170	$10	$17.3K
0012A	N/A	270	$40	$10.3K
G0467	Federally 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…	490	$20	$10.2K
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…	7,840	$1	$7.8K
0011A	N/A	230	$30	$7.4K
3725F	The provider screens a patient with dementia for the presence of depression, which is a mental disorder characterized by sadness, guilt feelings, hopelessness, or irritability.	1,270	$1	$5.1K
3077F	No Summary found for this code	820	$10	$4.1K
3079F	No Summary found for this code	960	$1	$3.8K
3074F	No Summary found for this code	1,270	$1	$3.8K

Showing 1–10 of 109

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Greater Philadelphia Health Action Inc. — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

109 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	17	1,690	760	$170	$1.2M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	528	980	310	$50	$136.6K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	156	190	290	$100	$114.6K
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…	490	820	230	$80	$71.7K
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…	221	8,160	210	$60	$68.4K
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…	606	660	180	$70	$63.7K
99201	Deleted code, effective Jan. 1, 2021	73	110	150	$80	$61.7K
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…	116	8,870	240	$40	$56.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	43	710	230	$70	$49.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	295	870	160	$70	$48.2K

Showing 1–10 of 109

Related Providers

Other providers that share a Tax Identification Number (TIN) with Greater Philadelphia Health Action Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greater Philadelphia Health Action Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$25.4M
Greater Philadelphia Health Action Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$21M
Greater Philadelphia Health Action Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$20.1M
Greater Philadelphia Health Action Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$12.3M
Greater Philadelphia Health Action, Inc.	PA	Federally Qualified Health Center (FQHC)	$0	$5.5M
Ron Mahlab	PA	Psychiatry Physician	$333.5K	$170
Christene Nyaboke	PA	Adult Health Nurse Practitioner	$214.6K	$0
Qaisar Usmani	NJ	Rheumatology Physician	$140.3K	$0
George Zappalorta	AR	Clinical Social Worker	$31.4K	$0
Koyejo Oyerinde	ND	Pediatrics Physician	$0	$6.4K

Nearby Providers

Other providers in the same ZIP code as Greater Philadelphia Health Action Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Citizen's Acting Together Can Help, Inc.	PA	Adult Mental Health Clinic/Center	$0	$20.4M
Gaudenzia, Inc.	PA	Community/Behavioral Health Agency	$0	$12.1M
Bethanna	PA	Community/Behavioral Health Agency	$0	$8.1M
Thomas Jefferson University	PA	Public Health or Welfare Agency	$0	$7.5M
Aloknath Pandya	PA	Internal Medicine Physician	$250.8K	$2K
Vincent Lam	PA	Ophthalmology Physician	$170.3K	$23.8K
Christopher Masiello	PA	Physical Therapist	$127.1K	$0
Shelby Rapp	PA	Occupational Therapist	$86K	$0
City Of Philadelphia	PA	Clinical Medical Laboratory	$40.4K	$4.3K
Morgan Ettlinger	PA	Speech-Language Pathologist	$38.4K	$0

Greater Philadelphia Health Action Inc. — Billing Profile & Reimbursement Data

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Greater Philadelphia Health Action 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

Related Providers

Nearby Providers

Frequently Asked Questions

References