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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Priority Health Systems Inc. (NPI 1649651357)

Field	Value
Entity Type	Organization
Organization	Priority Health Systems Inc.
Address	143 Kennedy St Nw
City	Washington
State	DC
ZIP	20011
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	June 18, 2015

Payer Source	Total Paid
Medicaid	$3M
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
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	12,220	$240	$3M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. District of Columbia Distribution

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

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — District of Columbia

Full comparison — all codes billed, vs. District of Columbia median

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	7	30	1,960	$230	$1.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Integrated Community Services, Inc.	DC	Home Health Agency	$0	$145.9M
National Children's Center, Inc.	DC	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$101M
Capital Care, Inc	DC	Home Health Agency	$0	$83.4M
Aba Inc	DC	In Home Supportive Care Agency	$0	$80.8M
Premium Select Home Care Inc	DC	Home Health Agency	$0	$63.9M
Ideal Nursing Services Inc	DC	Home Health Agency	$0	$58M
Total Care Services, Inc.	DC	Developmentally Disabled Services Day Training Agency	$0	$54.7M
Metro Homes Inc	DC	Developmental Disabilities Clinic/Center	$0	$45.1M
Citycare Health Services, Inc	DC	Community/Behavioral Health Agency	$0	$36.4M
Janilcar Inc	DC	Durable Medical Equipment & Medical Supplies	$0	$32.7M

Priority Health Systems Inc. — Billing Profile & Reimbursement Data

Sign up for Priority Health Systems Inc. — Billing Profile & Reimbursement Data policy alerts

Priority Health Systems Inc. — Billing Profile & Reimbursement Data

Sign up for Priority Health Systems Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References