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

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

Fallbrook Family Health Center (NPI 1831487776)

Fallbrook Family Health Center is a family medicine physician provider located in Lincoln, Nebraska. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Fallbrook Family Health Center
Address	755 Fallbrook Blvd
City	Lincoln
State	NE
ZIP	68521
Taxonomy	Family Medicine Physician
NPI Enumerated	July 13, 2011

Payer Source	Total Paid
Medicaid	$273.8K
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,410	$80	$183K
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…	1,110	$60	$64.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	550	$20	$11.5K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	160	$40	$7.2K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	70	$50	$3.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	110	$20	$1.7K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	70	$20	$1.1K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	40	$20	$810
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	240	$1	$470
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	20	$20	$300

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Fallbrook Family Health Center — 0 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	305	700	660	$70	$305.1K
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…	146	600	610	$70	$251.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	61	100	240	$50	$28.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	107	210	110	$10	$19.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	188	270	1,170	$1	$16.8K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	91	130	200	$20	$13.3K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	16	30	100	$40	$12.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	41	140	180	$20	$12.6K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	57	70	150	$20	$12.1K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	17	20	110	$10	$3.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Lincoln, Nebraska	NE	Land Ambulance	$2.2M	$8.2M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$6.8M
Nebraska Urban Indian Health Coalition, Inc.	NE	Primary Care Clinic/Center	$0	$2M
Above And Beyond Aba Ne, LLC	NE	Behavior Analyst	$0	$714.5K
North Lincoln Family Medical Center PC	NE	Family Medicine Physician	$0	$663.1K
Innovative Community Health Institute LLC	NE	Family Medicine Physician	$0	$503.6K
Husker Rehabilitation And Wellness Centers, P.C.	NE	Physical Therapist	$0	$446.7K
Huy Pham	NE	Optometrist	$2.6K	$393.8K
Intentions Psychotherapy PC	NE	Mental Health Counselor	$0	$273.5K
Bradlee N Novotny, D.c., P.C.	NE	Physical Medicine & Rehabilitation Physician	$0	$247.3K

Fallbrook Family Health Center — Billing Profile & Reimbursement Data

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Fallbrook Family Health Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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