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

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

Full Circle Health, Inc. (NPI 1841490075)

Key Findings

Field	Value
Entity Type	Organization
Organization	Full Circle Health, Inc.
Address	777 N Raymond St
City	Boise
State	ID
ZIP	83704
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 25, 2007

Payer Source	Total Paid
Medicaid	$53.3M
Medicare	$0

FULL CIRCLE HEALTH, INC. shows effectively single-payer activity: there is no Medicare billing on file (none) while reported Medicaid revenue totals $53.3M, indicating the organization’s visible reimbursement footprint is almost entirely Medicaid-driven. Analysts should treat Medicaid as the primary—and for these data, the sole—revenue source when modeling payer mix or network leverage.

Revenue is extremely concentrated in a single line item: the top 3 Medicaid codes account for 99.7% of the provider’s total Medicaid revenue, with T1015 alone representing $52.8M and 99.1% of Medicaid revenue. This concentration means overall revenue trends for the practice will largely track utilization and reimbursement for a single bundled clinic visit code.

The provider’s taxonomy as a Federally Qualified Health Center (FQHC) aligns with its dominant use of FQHC/clinic encounter codes: T1015 (clinic visit/encounter, all-inclusive) and G0467 (FQHC visit, established patient) are the top revenue drivers. This code mix suggests the organization operates as a community health center delivering bundled, face-to-face primary care encounters consistent with FQHC payment models rather than fee-for-service specialty procedures.

FULL CIRCLE is a statewide outlier on T1015: it ranks #1 of 143 providers in-state (100th percentile; extreme outlier) for that code and therefore appears to be the dominant source of T1015 revenue in Idaho. That rank indicates unusually high volume or concentration for the clinic-visit bundle compared with peers, which has direct implications for network contracting and capitation discussions.

Higher-level E/M codes show unusual claim volumes but very low average payments: 99214 appears at 57K claims with a $3 avg paid/claim and $171K revenue, ranking #7 of 618 in-state (99th percentile; extreme outlier), and 99213 shows 81.5K claims at $1 avg paid/claim and $81.5K revenue, ranking #6 of 669 (99th percentile; extreme outlier). These patterns indicate heavy use of standard E/M visit coding alongside bundled FQHC billing, with Medicaid average paid amounts per E/M claim that are minimal in the dataset provided.

G0467 is also materially used and ranks well above peers: 13.7K claims, $11 avg paid/claim, $150.8K revenue and #3 of 32 providers in-state (94th percentile; notably above typical state volume for this code). The combination of strong G0467 and dominant T1015 activity reinforces an operational focus on FQHC-style clinic encounters rather than inpatient or procedure-heavy services.

Several high-volume service codes report $0 avg paid/claim (for example 90686 with 7.2K claims, 90471 with 20.3K claims, 90472 with 11.9K claims, and preventive codes 99391/99392 with multiple thousand claims each). This indicates substantial service throughput for vaccinations and preventive visits in the encounter counts, but little to no separately recorded Medicaid payment for those specific line items in these data — further claims-level or contract review is needed to determine whether these services are bundled, reimbursed through an alternate mechanism, or recorded differently in state systems.

The NPI was enumerated on 2007-07-25 (~19 years ago), indicating a long-standing presence in the market. That tenure, coupled with a highly concentrated $53.3M Medicaid revenue base and top-state rankings on FQHC encounter codes, suggests an established community clinic operating primarily within Idaho’s Medicaid ecosystem rather than as a Medicare-facing or specialty provider.

Medicaid: Complete Services Breakdown

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

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	247,970	$210	$52.8M
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…	56,990	$1	$171K
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…	13,710	$10	$150.8K
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…	81,480	$1	$81.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	440	$90	$39.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	280	$60	$15.4K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	150	$80	$12.3K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	60	$30	$1.9K
59514	The provider admits the patient to the hospital for delivery, delivers the fetus and placenta via an abdominal incision, and provides care immediately after delivery on the same date of service. This…	10	$140	$1.7K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	20	$60	$1K

Showing 1–10 of 84

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Full Circle Health, Inc. — 3 of 17 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	1	140	5,470	$180	$2.6M
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…	6	670	740	$40	$193.6K
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	620	560	$60	$191.8K
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…	214	410	740	$60	$174.3K
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…	11	80	450	$80	$171.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	43	60	1,370	$50	$151.3K
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…	12	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10	80	130	$80	$91.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	24	30	1,070	$30	$73.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	26	30	790	$30	$68.4K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sky Blue	ID	Infectious Disease Physician	$51.9K	$0
Zechariah Wilson	ID	Family Medicine Physician	$30.2K	$0
Scot Scheffel	ID	Sports Medicine (Family Medicine) Physician	$22.9K	$0
Brian Hopkins	ID	Family Medicine Physician	$9.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Connections, Inc	ID	Case Management Agency	$0	$30M
K A Health Services LLC	ID	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.9M
County Of Ada	ID	Land Ambulance	$2M	$11.4M
Developmental Concepts, Inc.	ID	Developmental Disabilities Clinic/Center	$0	$13.2M
Pathways Of Idaho, LLC	ID	Community/Behavioral Health Agency	$0	$12M
Havenwood Caregiver Services Of Idaho, LLC	ID	In Home Supportive Care Agency	$0	$10.7M
Living Independently Forever, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$9.8M
Community Partnerships Of Idaho, Inc.	ID	Developmental Disabilities Clinic/Center	$0	$7.6M
All Horizons Inc	ID	Mental Health Counselor	$0	$6.7M
Ascent Behavioral Health Services	ID	Community/Behavioral Health Agency	$0	$4.7M

Full Circle Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Full Circle Health, Inc. — Billing Profile & Reimbursement Data policy alerts

Full Circle Health, Inc. — Billing Profile & Reimbursement Data

Sign up for Full Circle Health, Inc. — Billing Profile & Reimbursement Data policy alerts

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