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

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

Agnesian Healthcare Inc (NPI 1760902191)

Field	Value
Entity Type	Organization
Organization	Agnesian Healthcare Inc
Address	371 E 1st St
City	Fond Du Lac
State	WI
ZIP	54935
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	June 27, 2017

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	25,130	$60	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	3,660	$90	$325.7K
0365T	Adaptive behavior tx addl	7,270	$30	$225.5K
0369T	Duodenal mucosal resurfacing, endoscopic	2,360	$40	$103.8K
0364T	Behavior treatment	7,710	$10	$38.6K
0368T	Behavior treatment modified additional	2,670	$10	$37.4K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	140	$30	$4.1K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	20	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Agnesian Healthcare Inc — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	13	110	5,170	$80	$1.5M
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	29	110	2,070	$120	$581.8K
0365T	Adaptive behavior tx addl	7	50	3,570	$70	$305.2K
0369T	Duodenal mucosal resurfacing, endoscopic	7	50	1,180	$100	$155.8K
0364T	Behavior treatment	5	50	3,670	$10	$68.2K
97156	The provider discusses a patient’s adaptive behavior treatment face–to–face with the guardian(s) or caregiver(s), with or without the patient present. Report this code for each 15 minutes that the…	66	80	200	$70	$60.4K
0368T	Behavior treatment modified additional	6	50	1,190	$30	$50K
0370T	Family adaptive behavior treatment guidance, administered by physician or other qualified health care professional (without the patient present)	20	30	350	$80	$31K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Agnesian Healthcare, Inc	WI	General Acute Care Hospital	$0	$17.8M
Agnesian Healthcare, Inc	WI	Community Based Hospice Care Agency	$0	$8.8M
Agnesian Healthcare Inc	WI	Family Medicine Physician	$0	$7.4M
Sameer Gupta	PA	Hematology & Oncology Physician	$2.9M	$0
Rahul Sawlani	WI	Diagnostic Radiology Physician	$329.3K	$29.7K
Mary Friess	WI	Family Nurse Practitioner	$328K	$15.8K
Vinod Alluri	TX	Psychiatry Physician	$187.4K	$88.4K
Garry Jean-louis	WI	Infectious Disease Physician	$205.7K	$0
Conrad Brimhall	TN	Dermatology Physician	$189.3K	$880
Bryce Beard	LA	Radiation Oncology Physician	$178.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Consultants Laboratory Of Wisconsin, LLC	WI	Clinical Medical Laboratory	$1.2M	$4.6M
Fond Du Lac County Dcp Case Management	WI	Case Management Agency	$0	$5.8M
Premier Care Of Wisconsin, LLC.	WI	Methadone Clinic	$0	$4.8M
Fond Du Lac Co Dcp Ccs Program	WI	Community/Behavioral Health Agency	$0	$4.3M
Fond Du Lac School District	WI	Local Education Agency (LEA)	$0	$2.5M
Agnesian Healthcare Enterprises LLC	WI	Durable Medical Equipment & Medical Supplies	$0	$2.2M
City Of Fond Du Lac	WI	Land Ambulance	$325.7K	$1.5M
The Arc Of Fond Du Lac	WI	Speech-Language Pathologist	$0	$1.8M
Blandine House Inc	WI	Substance Abuse Rehabilitation Facility	$0	$1.3M
Waupun Memorial Hospital	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.2M

Agnesian Healthcare Inc — Billing Profile & Reimbursement Data

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Agnesian Healthcare 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