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.

Denver Health And Hospital Authority (NPI 1801837810)

Field	Value
Entity Type	Organization
Organization	Denver Health And Hospital Authority
Address	1100 Federal Blvd
City	Denver
State	CO
ZIP	80204
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$40.3M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-focused provider: it reports no Medicare revenue on file and $40.3M in lifetime Medicaid revenue, so analyses of scale, utilization, and competitive standing should treat it as a single‑payer (Medicaid) operation rather than a mixed Medicare/Medicaid practice. The NPI was enumerated 2006-06-09 (~20 years ago), indicating long tenure in the market and an established billing history under its FQHC taxonomy.

Revenue concentration is very high: the top 3 Medicaid codes by revenue account for 67.0% of this provider's total Medicaid revenue, with 99213 alone generating $18.2M (45.8% of Medicaid revenue). That concentration means a small set of visit-type E&M and screening services dominate the provider’s Medicaid receipts and should be the focus of payer contract and utilization reviews.

The code mix shows this organization operates primarily as a high-volume primary care and pediatric outpatient practice: 99213 (130.7K claims, $139 avg paid/claim, $18.2M revenue) and 99214 (36.6K claims, $116 avg paid/claim, $4.2M revenue) together reflect large volumes of established patient E&M visits, while pediatric preventive visit codes 99393 (20.2K claims, $130 avg paid/claim, $2.6M revenue), 99391 (18.5K claims, $104 avg paid/claim, $1.9M revenue), and 99394 (13.5K claims, $135 avg paid/claim, $1.8M revenue) underscore a substantial child/adolescent preventive services footprint.

Clinical operations emphasize developmental screening and behavioral health integration: 96110 (24.2K claims, $171 avg paid/claim, $4.1M revenue) ranks as a top revenue code, and behavioral health codes such as H0025 (11.2K claims, $132 avg paid/claim, $1.5M revenue), H0002, and psychotherapy 90832 also appear in the top codes list. Together these items suggest routine, standardized developmental screening and embedded behavioral‑health prevention/screening are core service lines at this FQHC.

Competitive standing in Colorado is dominant for multiple codes: the provider ranks #7 of 2515 for 99213 (100th percentile; extreme outlier), #34 of 2632 for 99214 (99th percentile; extreme outlier), and #5 of 275 for 96110 (99th percentile; extreme outlier). It also ranks #1 of 292 for 99393 and #1 of 276 for 99394 (both 100th percentile; extreme outliers), indicating this center is a major statewide source of pediatric preventive and high-volume E&M services relative to peers.

The FQHC-specific code presence and pattern is notable: G0467 appears with 13.8K claims ($8 avg paid/claim, $110.4K revenue) and ranks #3 of 107 in-state (98th percentile; extreme outlier), confirming the provider is billing typical FQHC encounter bundles frequently even though those bundles contribute only a small fraction of total Medicaid dollars. That mismatch—high FQHC encounter volume but low per-claim reimbursement—reflects the expected reimbursement structure for FQHCs and should be considered when comparing per-claim revenue to non-FQHC peers.

There is an operational risk dimension from the heavy reliance on a few high-volume visit codes: 99213 alone comprises $18.2M of $40.3M in Medicaid revenue, and the top 3 codes together make up 67.0% of Medicaid receipts. Any changes in Medicaid visit coding rules, rates, or utilization management for outpatient E&M or developmental screening could therefore have outsized impacts on this provider’s revenue base.

Ancillary service mix is present but materially smaller: dental preventive and restorative codes (D1120, D0120, D2392, D2391, D1206) and immunization/COVID vaccine codes (90480) appear in the top-25 but each contributes under 1% individually. These items indicate a breadth of services consistent with an FQHC model—primary care, pediatric prevention, behavioral health, developmental screening, and some dental services—while reinforcing that the Medicaid revenue profile is dominated by routine outpatient E&M and screening codes.

Medicaid: Complete Services Breakdown

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

85 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…	130,730	$140	$18.2M
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…	36,580	$120	$4.2M
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	24,230	$170	$4.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20,160	$130	$2.6M
D0999	N/A	9,130	$230	$2.1M
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…	18,540	$100	$1.9M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	13,510	$140	$1.8M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	11,190	$130	$1.5M
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,…	10,520	$130	$1.4M
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…	4,030	$80	$330.2K

Showing 1–10 of 85

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

Denver Health And Hospital Authority — 17 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

85 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	39	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…	7	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…	34	2,630	430	$90	$268.2K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	5	100	320	$80	$229.2K
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	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…	4	260	380	$100	$161.6K
D2392	Post 2 surface resin‑based composite	242	690	290	$130	$148K
H0031	Mental health assessment, by non-physician	103	130	210	$140	$125K
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…	541	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,…	17	690	140	$90	$118.4K

Showing 1–10 of 85

Related Providers

Other providers that share a Tax Identification Number (TIN) with Denver Health And Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Health And Hospital Authority	CO	General Practice Physician	$0	$95M
Denver Health And Hospital Authority	CO	General Acute Care Hospital	$0	$77.1M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$68.5M
Denver Health And Hospital Authority	CO	Ambulance	$3.4M	$46.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$29.4M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$28.2M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$25.5M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$17.4M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$15.2M
Denver Health And Hospital Authority	CO	Urgent Care Clinic/Center	$0	$12M

Nearby Providers

Other providers in the same ZIP code as Denver Health And Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$9.5M
Fresenius Medical Care Dialysis Services Colorado LLC	CO	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.7M
Youth Vision Of Denver, LLC	CO	Optometrist	$0	$7.3M
Denver Youth Dentistry, PC	CO	General Practice Dentistry	$0	$5.8M
Stadium Medical, Inc.	CO	Ambulance	$1.1M	$4.2M
Mile High Dental Prof LLC	CO	General Practice Dentistry	$0	$3.5M
Cristos Ifantides	CO	Ophthalmology Physician	$305.4K	$0
Misha Miller	CO	MOHS-Micrographic Surgery Physician	$296.6K	$0
David Opperman	CO	Otolaryngology Physician	$214.5K	$0
Jeff Foster	CO	Acute Care Nurse Practitioner	$187.2K	$0

Denver Health And Hospital Authority — Billing Profile & Reimbursement Data

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Denver Health And Hospital Authority — 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