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

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

Erie Family Health Center, Inc (NPI 1760499545)

Field	Value
Entity Type	Organization
Organization	Erie Family Health Center, Inc
Address	1701 W Superior St
City	Chicago
State	IL
ZIP	60622
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicaid	$143M
Medicare	$0

Key Findings

ERIE FAMILY HEALTH CENTER, INC reports no Medicare billing on file and $143M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) operation on the available data. Its NPI was enumerated 2006-08-02 (~20 years ago), indicating long-tenured participation in public programs and an established presence in the market.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 98.4% of the provider's total Medicaid revenue, with a single code, T1015, contributing $137.6M and representing 96.3% of the provider's Medicaid revenue. This concentration signals that clinic-encounter billing drives the overwhelming share of revenue and that small changes in the payment or utilization of those few codes would materially affect overall revenue.

The dominant code T1015 (Clinic visit/encounter, all-inclusive) and its $137.6M revenue share indicate the organization operates primarily as a high-volume outpatient clinic consistent with its FQHC taxonomy. The all-inclusive clinic visit coding suggests bundled primary care and wraparound services delivered at scale, reflecting a visit-based, ambulatory service model rather than a procedure- or specialty-driven revenue mix.

T1040 (Medicaid certified community behavioral health clinic services, per diem) contributes $1.5M and ranks #1 of 191 providers in-state (100th percentile; extreme outlier), showing an integrated behavioral-health unit or MCBHC program at scale. The presence of a top-ranked per-diem behavioral health code alongside the clinic visit volume implies the FQHC is delivering both primary care and structured behavioral-health services to its Medicaid population.

The third top code, D0999 ($1.5M, rank #30 of 219, 87th percentile; characterized as typical, unremarkable volume), is included in the revenue concentration but lacks a description on file; its placement as a top revenue contributor despite being labeled typical suggests a catch-all or miscellaneous billing component that materially complements the clinic-visit and behavioral-health revenue lines. Analysts should treat D0999 as a substantive but less distinctive revenue source relative to the clearly described dominant codes.

Obstetric and postpartum services are a notable part of the service mix: 59409 (vaginal delivery) appears with $904.3K (rank #6 of 174, 97th percentile; notably above typical state volume) and 59430 (routine postpartum care) has $37.9K and ranks #1 of 143 providers in-state (100th percentile; extreme outlier). These rankings indicate the provider offers meaningful maternal-child services and is a high-volume local provider for delivery-related care within the Medicaid population.

Contraceptive and preventive care volumes are also pronounced: high ranks and extreme outlier labels for codes such as 58300 (IUD placement, rank #1 of 41, 100th percentile), J7297 (Liletta IUD, rank #1 of 7, 100th percentile), and multiple vaccine codes (e.g., 90670 with 26.9K claims, rank #1 of 989, 100th percentile; 90658 and 90649 also at top percentiles). This pattern points to robust reproductive health and immunization programs consistent with FQHC preventive-care priorities and high-volume pediatric/adolescent services.

State-level competitive standing is strong and specialized: the provider ranks #1 in multiple high-volume codes (including T1015, T1040, 90670, 58300, and 59430) and shows numerous 100th-percentile or extreme outlier labels, marking it as a dominant Medicaid safety-net provider in Illinois for those service lines. At the same time, the complete absence of Medicare billing on file means its market footprint is concentrated in Medicaid populations rather than dual-eligible or fee-for-service Medicare cohorts, which is important for payer-strategy and network contracting analyses.

Medicaid: Complete Services Breakdown

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

218 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	910,960	$150	$137.6M
T1040	Medicaid certified community behavioral health clinic services, per diem	21,550	$70	$1.5M
D0999	N/A	13,100	$110	$1.5M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	1,000	$910	$904.3K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	230	$1,010	$232K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	400	$450	$179.4K
0002A	N/A	3,890	$40	$163.2K
0001A	N/A	3,750	$40	$153.8K
90649	This code represents a quadrivalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against four HPV types (6, 11, 16,…	3,680	$20	$69.9K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	26,900	$1	$53.8K

Showing 1–10 of 218

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Erie Family Health Center, Inc — 21 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

218 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	1	850	7,490	$120	$3.9M
D0999	N/A	30	220	1,090	$110	$610.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	243	280	1,120	$30	$218.9K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	6	170	50	$910	$144.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	1	190	880	$70	$128.2K
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…	49	1,180	370	$90	$109.7K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	5	40	20	$630	$97.6K
D1120	Prophylaxis–child	187	2,140	960	$40	$89.1K
D1351	Sealant - per tooth	285	1,270	530	$60	$87.1K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	314	510	230	$160	$83.3K

Showing 1–10 of 218

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$13.8M
Erie Family Health Center, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$12.7M
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$12.4M
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$11.2M
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$9.5M
Erie Family Health Center, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$6.7M
Erie Family Health Center, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$2.9M
Kate Lynn Maxouris	IL	Family Medicine Physician	$13.9K	$233.2K
Maribe Bangayan	IL	Pulmonary Disease Physician	$78.8K	$164.1K
Jason Kalk	IL	Foot & Ankle Surgery Podiatrist	$91.7K	$46.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Primecare Community Health, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$11.3M
Orbit Medical Of Chicago LLC	IL	Durable Medical Equipment & Medical Supplies	$0	$10.7M
Primecare Community Health Inc	IL	Federally Qualified Health Center (FQHC)	$0	$8.5M
Primecare Community Health Inc	IL	Federally Qualified Health Center (FQHC)	$0	$5.3M
Ayman Jabr	IL	Family Medicine Physician	$193.6K	$4.3M
Presence Chicago Hospitals Network	IL	General Acute Care Hospital	$0	$4.4M
Lubov Klemine	IL	Family Medicine Physician	$2.3K	$3.6M
James Diesfeld	IL	Interventional Pain Medicine Physician	$32.6K	$3.5M
Eric Chuang	IL	Internal Medicine Physician	$1.5M	$1.7M
Ogbonnaya Aneziokoro	IL	Nephrology Physician	$525.3K	$1.8M

Erie Family Health Center, Inc — Billing Profile & Reimbursement Data

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Erie Family Health Center, 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