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

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

Community Health Services, Inc. (NPI 1730284605)

Key Findings

Field	Value
Entity Type	Organization
Organization	Community Health Services, Inc.
Address	500 Albany Ave
City	Hartford
State	CT
ZIP	06120
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 14, 2006

Payer Source	Total Paid
Medicaid	$59.4M
Medicare	$0

COMMUNITY HEALTH SERVICES, INC. is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and total Medicaid revenue reported is $59.4M, indicating the organization operates primarily within Medicaid payment streams rather than dual Medicare/Medicaid revenue mix.

Revenue concentration is extremely high: the precomputed top‑3 Medicaid codes account for 97.5% of the provider's Medicaid revenue, with a single code, T1015, representing $57.1M (96.1% of Medicaid revenue). This signals that most Medicaid dollars flow through the FQHC all‑inclusive clinic visit payment rather than a diversified mix of high‑revenue procedures.

The code mix and taxonomy align with an FQHC operational model: T1015 (Clinic visit/encounter, all‑inclusive) plus presence of FQHC‑specific codes such as G0467 and G0470 indicate per‑visit bundled billing for face‑to‑face primary care and behavioral health services typical of federally qualified health centers. The dominance of T1015 revenue suggests the provider relies on bundled, visit‑based reimbursement rather than procedure‑heavy specialties.

Competitive standing on the highest‑revenue code is modest: T1015 ranks #10 of 73 providers in‑state (88th percentile) and is labeled typical/unremarkable state volume, which means although T1015 drives nearly all revenue here, the provider is not an outlier leader in the state for that particular FQHC visit code. Other FQHC visit codes such as G0467 rank #7 of 33 (81th percentile) and G0470 ranks #13 of 25 (50th percentile), reinforcing a mid‑to‑upper state presence but not dominance across FQHC peers.

Several evaluation‑and‑management codes show unusually high claim activity relative to peers: 99213 has 132.8K claims and $398.5K revenue and is flagged as an "extreme outlier" (99th percentile), while 99214 (49.4K claims, $296.3K) and 99212 (16.6K claims, $83.2K) are described as "notably above typical" (98th percentile each for 99214 and 99212). These labels indicate evaluation/management visit volume is far higher here than typical in‑state patterns, even though per‑claim payments on some E/M codes are low.

Service mix includes routine chronic disease monitoring and behavioral health: codes such as 82962 (18.8K claims, $150.4K), 83036 (12.4K claims, $74.7K), 90832/90834 (20.3K/22.6K claims, $121.9K/$113K) and 90791 (2.1K claims, $2.1K) show regular use of diabetes self‑monitoring, A1C testing, and psychotherapy services, consistent with comprehensive primary care and integrated behavioral health typical of FQHCs. These secondary codes contribute modest revenue compared with T1015 but reflect the clinical breadth of services delivered.

Telehealth and remote‑site FQHC billing appears limited: G2025 (telehealth distant site FQHC) shows 387 claims and $26.7K revenue and ranks at the 4th percentile in‑state, indicating relatively low telehealth adoption or limited reimbursement capture for telehealth compared with peer FQHCs. This could reflect site operational choices, patient access factors, or historical coding patterns.

The provider has long tenure in the registry, with NPI enumerated 2006-09-14 (~20 years ago), which, combined with a concentrated T1015 revenue stream and large Medicaid volume, suggests an established FQHC operating model that primarily monetizes bundled clinic visits rather than diversified fee‑for‑service procedures. Analysts evaluating network contracting or risk attribution should view this entity as a Medicaid‑dependent FQHC with high visit volumes and specialized coding concentration rather than a multi‑payer, procedure‑driven provider.

Medicaid: Complete Services Breakdown

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

131 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	402,220	$140	$57.1M
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	10,410	$40	$426.8K
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…	132,840	$1	$398.5K
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…	16,260	$20	$357.6K
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…	49,390	$10	$296.3K
82962	Blood glucose monitoring at home with small electronic devices is an easy method to check blood sugar level on a daily basis. The patient himself can perform the procedure and the result is obtained…	18,810	$10	$150.4K
90832	In 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…	20,320	$10	$121.9K
90834	In 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…	22,600	$10	$113K
11720	The provider surgically debrides (debulks or removes) 1 to 5 abnormal, diseased, or infected nails.	2,410	$40	$94K
99212	The 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,…	16,640	$10	$83.2K

Showing 1–10 of 131

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Community Health Services, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

131 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	10	70	830	$150	$24M
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…	34	1,590	740	$50	$331.8K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	26	30	2,590	$60	$278.5K
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…	22	1,710	750	$30	$243.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	35	50	1,060	$50	$230.5K
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…	14	170	850	$80	$203.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	975	2,180	850	$90	$202.1K
90832	In 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…	41	420	1,230	$20	$199.3K
90834	In 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…	28	570	410	$50	$197.6K
76801	In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…	23	50	1,160	$80	$189.3K

Showing 1–10 of 131

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Smith	CT	Specialist	$33.8K	$1.1M
Jeffrey Marzian	KY	Podiatrist	$60.2K	$0
Valerie Rash	KY	Podiatrist	$25.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Substance Abuse Centers, Inc.	CT	Substance Use Disorder Rehabilitation Clinic/Center	$199.5K	$19.6M
Community Renewal Team, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$7.3M
Hartford Community Mental Health Center Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.3M
Terrence Oder	CT	Nephrology Physician	$293.4K	$0
Sarah Yiznitsky	CT	Family Nurse Practitioner	$171.6K	$0
Andrew Baginski	CT	Medical Physician Assistant	$47.3K	$0

Community Health Services, Inc. — Billing Profile & Reimbursement Data

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Community Health Services, Inc. — Billing Profile & Reimbursement Data

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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