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

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

Pueblo Community Health Center Inc (NPI 1770529950)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pueblo Community Health Center Inc
Address	300 Colorado Ave
City	Pueblo
State	CO
ZIP	81004
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 22, 2006

Payer Source	Total Paid
Medicaid	$55.3M
Medicare	$0

This provider is effectively a single‑payer Medicaid operation for the period on file: there is no Medicare billing on file while total Medicaid revenue is $55.3M, indicating the organization’s scale and financial footprint are driven almost entirely by Medicaid. Analysts should treat Medicare-related performance as unavailable rather than as a material contributor to revenue.

Revenue is highly concentrated in a very small set of outpatient E/M codes: the precomputed top three Medicaid codes (99213, 99214, 99212) account for 87.2% of the provider’s Medicaid revenue. The individual contributions are large — 99213 accounts for $30.4M (55.2%), 99214 for $15.5M (28.1%), and 99212 for $2.1M (3.8%) — which signals dependence on routine established‑patient office visits.

The taxonomy and code mix are consistent with an FQHC delivering high‑volume primary care and preventive services: as a Federally Qualified Health Center, the provider’s dominant codes 99213/99214/99212 reflect frequent established‑patient visits and chronic care management, while 99391 and 99392 (well visits) and 90471 (vaccination) show routine preventive and immunization activity. This blend suggests daily operations are centered on ambulatory primary care with built‑in preventive and immunization workflows.

The provider is a statewide volume leader for its top E/M codes: 99213 ranks #5 of 2515 providers in Colorado and 99214 ranks #7 of 2632 providers, both at the 100th percentile and labeled as extreme outliers. 99212 also ranks highly (#15 of 693, 98th percentile), so across the board the organization is far above typical state volume for core primary care E/M services and should be considered a dominant Medicaid primary‑care hub in Colorado.

Beyond primary care E/M, the provider reports notable behavioral health and maternity imaging activity. Psychotherapy codes 90834 (14.5K claims, $1.9M) and 90832 (4.4K claims, $610.8K) appear in the top codes, and obstetric ultrasound 76817 (1.5K claims, $186.9K) ranks #2 of 57 in‑state (98th percentile), indicating integrated behavioral‑health offerings and capacity for prenatal imaging. These secondary service lines diversify care delivery beyond routine office visits.

Operational indicators specific to FQHC billing and telehealth are present: G0467 shows 12K claims ($227.4K) and ranks #4 of 107 providers (97th percentile), reflecting the FQHC per‑visit bundle in Medicaid billing, and G2025 telehealth distant‑site payments total 1.4K claims ($21.9K) and rank #6 of 57 (91st percentile). Together these entries support that the organization bills both bundled FQHC visit codes and a measurable amount of telehealth.

High procedural throughput in lower‑paid, high‑volume items is also visible and classified as statistical outliers: 90471 (34.7K claims, $34.7K revenue) ranks #8 of 1206 providers (99th percentile) and 96372 (8.5K claims, $25.6K revenue) ranks #5 of 365 providers (99th percentile), both labeled as extreme outliers. These volumes imply substantial vaccination and injection administration capacity that complements the primary care visit volumes.

The provider’s NPI has been enumerated since 2006‑06‑22 (~20 years ago), indicating long tenure in the market; combined with the extreme statewide volumes on core E/M codes, this longevity likely underpins established referral and patient panels that drive the reported Medicaid revenues. Given that 87.2% of Medicaid revenue is tied to three outpatient E/M codes, the provider’s financials are sensitive to shifts in visit volume or reimbursement for those codes, making them a strategic partner or focal point for Medicaid program planning and network decisions.

Medicaid: Complete Services Breakdown

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

128 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	149,650	$200	$30.4M
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…	83,600	$190	$15.5M
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,…	11,190	$190	$2.1M
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…	14,470	$130	$1.9M
99391	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…	5,870	$240	$1.4M
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…	3,360	$240	$793.9K
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…	4,360	$140	$610.8K
D0999	N/A	2,250	$220	$488.5K
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…	2,280	$180	$416.3K
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…	11,970	$20	$227.4K

Showing 1–10 of 128

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Pueblo Community Health Center Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

128 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	74	150	2,140	$260	$2M
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…	5	2,520	330	$100	$352K
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…	7	2,630	430	$90	$268.2K
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…	1,398	1,670	550	$100	$229.3K
99391	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…	22	240	550	$110	$208.5K
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…	37	260	380	$100	$161.6K
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…	14	590	200	$80	$119.9K
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,…	15	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	74	290	160	$110	$111.1K
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…	69	720	130	$100	$110K

Showing 1–10 of 128

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Catholic Health Initiatives Colorado	CO	General Acute Care Hospital	$0	$23.6M
Family Support Center Of Colorado, LLC	CO	Adolescent and Children Mental Health Clinic/Center	$0	$6.9M
Usacs Of Colorado Inc	CO	Emergency Medicine Physician	$0	$5.6M
Southern Colorado Health & Rehab	CO	Physical Therapist	$0	$5.5M
Rothall, Inc.	CO	Parenteral & Enteral Nutrition Supplies (DME)	$0	$4.6M
Jandyco, LLC	CO	Addiction Medicine (Family Medicine) Physician	$0	$4.1M
Rehab For All LLC	CO	Community/Behavioral Health Agency	$0	$3.5M
Colorado Treatment Services LLC	CO	Methadone Clinic	$260.8K	$0
Melchor Sipalay	CO	Internal Medicine Physician	$236.1K	$0
Scott Harberts	CO	Nephrology Physician	$179.4K	$0

Pueblo Community Health Center Inc — Billing Profile & Reimbursement Data

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Pueblo Community 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pueblo Community Health Center Inc	CO	Federally Qualified Health Center (FQHC)	$0	$7.7M
Pueblo Community Health Center Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$6M
Pueblo Community Health Center Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$3.9M
Sergio Murillo Herrera	CO	Family Medicine Physician	$168.3K	$0
Melissa Dunn	CO	Obstetrics & Gynecology Physician	$112.1K	$0
Joseph Bulow	CO	Physician Assistant	$108K	$0
Julie Tenbrook	MN	Psychiatric/Mental Health Nurse Practitioner	$5.8K	$0