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

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

Group Health, Inc. (NPI 1710924683)

Field	Value
Entity Type	Organization
Organization	Group Health, Inc.
Address	4730 Chicago Ave
City	Minneapolis
State	MN
ZIP	55407
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	June 1, 2006

Payer Source	Total Paid
Medicaid	$204M
Medicare	$0

Key Findings

GROUP HEALTH, INC. is effectively a Medicaid-focused provider: the organization shows $204M in lifetime Medicaid revenue and has no Medicare billing on file, making Medicaid the dominant (and only reported) public payer exposure for this NPI. The NPI was enumerated on 2006-06-01 (~20 years ago), indicating long tenure in the market but a payer footprint concentrated in Medicaid.

Medicaid revenue is highly concentrated in a small set of evaluation-and-management (E/M) services: the precomputed top three Medicaid codes (99214, 99213, 99233) account for 49.0% of this provider’s total Medicaid revenue, with 99214 reporting $28.9M (21.2%), 99213 reporting $23.4M (17.2%), and 99233 reporting $14.5M (10.6%). This concentration shows the practice’s financial reliance on high-volume outpatient established visits and subsequent inpatient follow-up care.

The provider is a statewide outlier on core ambulatory E/M codes: 99214 (437.3K claims, $66 avg paid/claim, $28.9M) ranks #3 of 1177 providers in-state (100th percentile) and is described as an "extreme outlier," while 99213 (497.3K claims, $47 avg paid/claim, $23.4M) ranks #2 of 1201 (100th percentile) and is also an "extreme outlier." These rankings indicate dominant scale relative to in-state peers for routine and higher-complexity office visits.

Operational scale is apparent from raw claim volumes and average payments: the practice billed 497.3K claims for 99213 and 437.3K claims for 99214, with average paid/claim of $47 and $66 respectively. Those claim counts, combined with the high statewide ranks, signal very large ambulatory throughput and likely multi-site or high-visit-volume clinic operations.

Clinical breadth extends beyond primary ambulatory care into inpatient, perinatal, and specialty services: notable Medicaid contributors include 99223 ($6.3M, 4.6%, rank #2 of 101, 99th percentile), 59400 ($3.5M, 2.6%, rank #1 of 22, 100th percentile) and 59510 ($1.5M, 1.1%, rank #1 of 5, 100th percentile), indicating significant obstetric/global delivery activity, and 92014/92004 (ophthalmology) lines that are both top-ranked in-state. This mix points to a multi-specialty clinic that handles outpatient primary care, inpatient admissions/discharges, obstetrics, and specialty outpatient services under the same billing entity.

The provider also reports meaningful volume for high-acuity and institutional services, showing capacity for sicker patients: 99291 (critical care) generated $3.2M and ranks #2 of 48 (98th percentile, described as "notably above typical"), 99239 (discharge day management) produced $2.1M and ranks #2 of 91 (99th percentile), and 99310 (nursing facility subsequent care) produced $2.8M and ranks #1 of 44 (100th percentile). These codes demonstrate that the organization bills both critical care episode time and post-acute/nursing-facility visits at above-typical statewide levels.

Beyond the top E/M drivers, the provider’s Medicaid revenue shows diversification into public-health, preventive, and diagnostic services: S0302 (EPSDT) generated $4.7M (rank #2 of 313, 100th percentile), U0003 (SARS-CoV-2 testing) generated $4.5M (rank #3 of 274, 99th percentile, "notably above typical"), and vaccination code 90460 generated $2.8M (rank #2 of 200, 99th percentile). While the top three E/M codes dominate (49.0%), this spread of mid-tier revenue lines indicates a large ambulatory population receiving preventive, pediatric, and testing services through the same provider.

Competitive nuance is mixed by service line: the practice is an "extreme outlier" and ranks at or near #1 in many high-volume outpatient codes (e.g., 99214, 99213, 99233, 92014, 99310, 99202), signaling clear market leadership in ambulatory and selected specialty services, while some ancillary services such as T1013 (interpretive services) are at more typical volumes (rank #12 of 211, 95th percentile). For payers and analysts, this pattern flags a single large Medicaid-focused billing entity with dominant outpatient scale in the state but variable dominance across other ancillary and support codes.

Medicaid: Complete Services Breakdown

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

660 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	437,340	$70	$28.9M
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…	497,280	$50	$23.4M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	273,370	$50	$14.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	65,560	$100	$6.3M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	57,810	$90	$5M
S0302	Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service)	155,970	$30	$4.7M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	51,260	$90	$4.5M
99203	The provider sees a new 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 provider…	69,270	$60	$4.4M
99204	The provider sees a new 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 provider…	40,960	$90	$3.7M
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	3,700	$950	$3.5M

Showing 1–10 of 660

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Minnesota Distribution

Group Health, Inc. — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Minnesota

Full comparison — all codes billed, vs. Minnesota median

660 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	2	10	80	$1,620	$1.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	102	160	580	$170	$1.8M
V5261	Hearing aid, digital, binaural, bte	2	10	40	$3,260	$1.7M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	146	210	980	$140	$1.7M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	10	60	$1,700	$1.1M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	30	340	$60	$890.4K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	2	10	260	$900	$836.6K
T1013	Sign language or oral interpretive services, per 15 minutes	12	210	560	$60	$822.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	120	400	$60	$685.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2	50	310	$130	$678K

Showing 1–10 of 660

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regions Hospital	MN	General Acute Care Hospital	$0	$44.4M
Saint Joseph Mercy Livingston Hospital	MI	General Acute Care Hospital	$0	$18.3M
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$14.8M
Group Health, Inc.	MN	Clinical Medical Laboratory	$2.4M	$11.5M
Group Health, Inc.	MN	Multi-Specialty Clinic/Center	$0	$13M
Group Health, Inc.	MN	Pediatric Dentistry	$0	$5.6M
Polly Quiram	MN	Ophthalmology Physician	$3.7M	$0
Peter Kent	MN	Rheumatology Physician	$1.6M	$0
Edwin Ryan	MN	Ophthalmology Physician	$1.5M	$0
Elizabeth Miller	MN	Rheumatology Physician	$1.3M	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Allina Health System	MN	Internal Medicine Physician	$0	$32.9M
Allina Health System	MN	General Acute Care Hospital	$0	$27M
Allina Health System	MN	Physical Medicine & Rehabilitation Physician	$0	$18.2M
Ebenezer Home Care	MN	Home Health Agency	$0	$9.9M
Amaana Adult Day Care Center Inc	MN	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Hennepin County	MN	Psychiatry Physician	$0	$9.3M
Southside Community Health Services, Inc.	MN	Federally Qualified Health Center (FQHC)	$0	$8.9M
Hospital Pathology Associates PA	MN	Anatomic Pathology & Clinical Pathology Physician	$0	$8.5M
Twincare Dental LLC	MN	General Practice Dentistry	$0	$6.2M
Covenire Care Nokomis, LLC - Dba The Waters Of Minnehaha	MN	Assisted Living Facility	$0	$6M

Group Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Group Health, Inc. — Billing Profile & Reimbursement Data policy alerts

Group Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Group Health, Inc. — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References