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.

La Clinica De Los Campesinos, Inc (NPI 1790786929)

Field	Value
Entity Type	Organization
Organization	La Clinica De Los Campesinos, Inc
Address	2501 Main St
City	Stevens Point
State	WI
ZIP	54481
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 10, 2005

Payer Source	Total Paid
Medicaid	$24.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file and lifetime Medicaid revenue is $24.3M, indicating the organization’s Medicare footprint is absent while Medicaid is the dominant financial channel for services. The NPI was enumerated 2005-08-10 (~21 years ago), so this is an established FQHC operation with a multi-year presence in the market.

Revenue is extremely concentrated around a small set of Medicaid codes: the precomputed top 3 Medicaid codes account for 97.2% of the provider’s total Medicaid revenue, with T1015 alone accounting for $23.2M (95.6% of total Medicaid revenue). That concentration means operational and reimbursement changes to the T1015 payment model would have outsized impact on the provider’s topline.

T1015 (clinic visit/encounter, all‑inclusive) is the primary business driver: 101.7K claims, $228 avg paid/claim, $23.2M revenue, and the provider ranks #4 of 60 in‑state (95th percentile; notably above typical state volume for this code). This pattern—very high claim volume and large share of Medicaid revenue under an FQHC bundled visit code—aligns with a Federally Qualified Health Center operating mainly under per‑encounter bundled FQHC payments rather than fee‑for‑service E/M codes.

Traditional E/M codes appear as modest, secondary sources of revenue: 99213 (9K claims, $25 avg, $225.7K; 0.9% of Medicaid revenue) and 99214 (4.7K claims, $31 avg, $146K; 0.6%) show typical, unremarkable volumes and percentiles (99213 ranks in the 92nd percentile among in‑state providers for that code). In other words, the practice relies on FQHC bundle payments for the bulk of clinical revenue rather than high volumes of standalone E/M billing.

Behavioral health and substance‑use services are present but not revenue dominant: 90837 (3K claims, $59 avg, $174.5K; 0.7%), 90834 (4K claims, $29 avg, $115.2K; 0.5%), and H0022 (2.2K claims, $38 avg, $85.1K; 0.4%) each appear with typical, unremarkable to mid‑range in‑state percentiles (86th, 84th, and 75th respectively). These lines suggest integrated behavioral health and SUD intervention capacity within the FQHC model, contributing meaningful encounter volume but only a small portion of total Medicaid revenue.

Dental services show very high claim volumes but low per‑claim payments and small overall revenue share: examples include D7140 (11.7K claims, $4 avg, $46.9K; 0.2%, rank #10 of 221, 96th percentile, notably above typical state volume), D2392 (11K claims, $4 avg, $44.2K; 0.2%, 97th percentile, notably above typical state volume), and D1206 (21.9K claims, $1 avg, $21.9K; 0.1%, 96th percentile, notably above typical state volume). These data indicate the provider is a high‑volume dental care deliverer for Medicaid enrollees by claim count relative to peers, but dental reimbursements are low on a per‑claim basis and together represent a small share of total Medicaid revenue.

Competitive position is concentrated: the provider is a major statewide reporter for the FQHC bundled visit code (T1015 rank #4/60, 95th percentile) but is only a modest participant on many other codes where volumes are described as "typical, unremarkable". Several dental codes and visit codes are described as "notably above typical state volume," indicating competitive strength in dental throughput and FQHC encounter volume even though overall Medicaid revenue remains heavily weighted to the single FQHC visit code.

Operationally, reliance on an all‑inclusive FQHC encounter code (T1015) combined with substantial dental and behavioral health claim volumes suggests a multi‑service community health center model that bills primarily under FQHC encounter bundles. Given the concentration—top 3 codes = 97.2% of Medicaid revenue—analysts should treat changes in FQHC encounter reimbursement, coding practices, or eligibility as high‑impact events for this provider’s financial profile.

Medicaid: Complete Services Breakdown

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	101,690	$230	$23.2M
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…	9,030	$30	$225.7K
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…	2,960	$60	$174.5K
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…	4,710	$30	$146K
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…	3,970	$30	$115.2K
H0022	Alcohol and/or drug intervention service (planned facilitation)	2,240	$40	$85.1K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	11,730	$1	$46.9K
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…	2,710	$20	$46.1K
D2392	Post 2 surface resin‑based composite	11,040	$1	$44.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	21,920	$1	$21.9K

Showing 1–10 of 90

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

La Clinica De Los Campesinos, Inc — 7 of 25 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

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	60	4,880	$230	$4.9M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	206	260	3,590	$20	$232.2K
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…	214	1,630	270	$40	$205.3K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	115	120	490	$100	$179.5K
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…	146	1,760	250	$40	$173.2K
H0022	Alcohol and/or drug intervention service (planned facilitation)	47	190	400	$30	$140.3K
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…	130	900	410	$70	$130.4K
D2392	Post 2 surface resin‑based composite	8	270	510	$60	$123.3K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	10	220	430	$50	$111.4K
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…	128	790	400	$40	$109.6K

Showing 1–10 of 90

Related Providers

Other providers that share a Tax Identification Number (TIN) with La Clinica De Los Campesinos, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joellen Kozlowski	WI	Psychologist	$6.4K	$0
Javier Rincon	WI	Family Medicine Physician	$1.6K	$60

Nearby Providers

Other providers in the same ZIP code as La Clinica De Los Campesinos, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Portage	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.9M
Aspirus Stevens Point Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$15.6M
Inclusa Inc	WI	Health Maintenance Organization	$0	$6.4M
Brittany Printz	WI	Behavior Analyst	$0	$5.2M
Stevens Point Area Public School District	WI	Local Education Agency (LEA)	$0	$3.1M
Emily Paschen	WI	Behavior Analyst	$0	$2.9M
Lincare Inc	WI	Durable Medical Equipment & Medical Supplies	$0	$2.2M
Northwest Counseling & Guidance Clinic	WI	Adolescent and Children Mental Health Clinic/Center	$0	$2M
Aspirus Stevens Point Hospital & Clinics, Inc.	WI	General Practice Physician	$0	$2M
County Of Portage	WI	Land Ambulance	$390.6K	$786K

La Clinica De Los Campesinos, Inc — Billing Profile & Reimbursement Data

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La Clinica De Los Campesinos, 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