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.

Affiliates Inc. (NPI 1851415129)

Field	Value
Entity Type	Organization
Organization	Affiliates Inc.
Address	265 Gladstone St
City	Idaho Falls
State	ID
ZIP	83401
Taxonomy	Developmentally Disabled Services Day Training Agency
NPI Enumerated	March 19, 2007

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

Key Findings

AFFILIATES INC. has no Medicare billing on file and is effectively a single-payer Medicaid provider, reporting Total Medicaid revenue of $9.9M. This concentrated payer mix means analyses of size, service mix, and competitive position should be centered on Medicaid activity rather than Medicare comparisons.

Revenue is highly concentrated in a small set of Medicaid codes: the top three codes (S5100, H2032, 97537) account for 64.2% of this provider's total Medicaid revenue. Those top three line items are S5100 ($2.8M revenue, 28.6% of Medicaid revenue), H2032 ($2M, 20.0%), and 97537 ($1.5M, 15.5%), so any change to utilization or rates for these codes would materially affect overall revenue.

The code mix and descriptions indicate AFFILIATES operates primarily as a day-training and community support agency: S5100 is day care services billed per 15 minutes, H2032 is activity therapy per 15 minutes, and 97537 is one-on-one community work reintegration training per 15 minutes. Significant secondary lines include behavioral health counseling (H0004, $1.4M, 14.7%) and comprehensive community support services (H2015, $1.4M, 14.3%), together reflecting a blended model of day habilitation plus therapeutic and community-support services.

On statewide competitive standing for high-volume codes, AFFILIATES generally ranks as a modest-to-meaningful participant rather than a dominant provider: S5100 ranks #8 of 37 providers in-state (81th percentile; typical, unremarkable volume for this code), H2032 ranks #13 of 41 (70th percentile; typical, unremarkable volume for this code), and 97537 ranks #11 of 41 (75th percentile; typical, unremarkable volume for this code). These placements indicate steady, above-median volume in key day-training lines but not an outlier market share for those specific codes.

AFFILIATES is a clear outlier only on comprehensive community support services: H2015 ranks #3 of 45 providers in-state (95th percentile; notably above typical state volume for this code). That elevated position for H2015 suggests a competitive strength or local specialization in comprehensive community support services relative to peers.

The provider’s claim-level economics show a mix of higher-paid counseling/assessment codes and high-volume, lower-paid training codes: for example H0004 has an avg paid/claim of $137 (10.6K claims, $1.4M revenue) and 96152 has $120 avg (954 claims, $114.5K), versus 97537 at $24 avg paid/claim with 63.8K claims ($1.5M). This combination of high-count, low-unit-rate training services plus targeted higher-rate therapy work shapes both capacity needs and revenue sensitivity to utilization changes.

Smaller revenue streams round out the portfolio and indicate additional service breadth: H2019 ($471.6K, 4.8% of Medicaid revenue) ranks #19 of 60 (69th percentile; typical, unremarkable volume), T1027 ($62.7K, 0.6%) ranks #15 of 44 (67th percentile; typical, unremarkable volume), and T1005 ($30.8K, 0.3%) ranks #3 of 4 (33th percentile; typical, unremarkable volume). These smaller lines point to offerings in therapeutic behavioral services, family training, and respite care but they are not major revenue drivers.

AFFILIATES’ NPI was enumerated 2007-03-19 (~19 years ago), indicating long tenure in the market; paired with $9.9M in Medicaid receipts and strong placement on H2015, this suggests an established, Medicaid-focused day-training and community-support operation with a local competitive niche in comprehensive community support services.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5100	Day care services, adult; per 15 minutes	33,970	$80	$2.8M
H2032	Activity therapy, per 15 minutes	34,070	$60	$2M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	63,780	$20	$1.5M
H0004	Behavioral health counseling and therapy, per 15 minutes	10,560	$140	$1.4M
H2015	Comprehensive community support services, per 15 minutes	16,390	$90	$1.4M
H2019	Therapeutic behavioral services, per 15 minutes	4,910	$100	$471.6K
96152	N/A	950	$120	$114.5K
T1027	Family training and counseling for child development, per 15 minutes	1,960	$30	$62.7K
T1005	Respite care services, up to 15 minutes	1,470	$20	$30.8K

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

Affiliates Inc. — 1 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0004	Behavioral health counseling and therapy, per 15 minutes	46	160	4,020	$140	$1.6M
H2032	Activity therapy, per 15 minutes	13	40	19,190	$50	$1.6M
97537	In this procedure, the provider works one on one with a patient to provide community work reintegration training. The training helps the injured or ill patient to return to employment and the…	11	40	30,150	$20	$1.2M
H2019	Therapeutic behavioral services, per 15 minutes	19	60	2,960	$120	$609.8K
96152	N/A	56	70	2,270	$80	$608.8K
S5100	Day care services, adult; per 15 minutes	8	40	9,710	$30	$577.7K
H2015	Comprehensive community support services, per 15 minutes	3	50	2,960	$100	$570.3K
T1005	Respite care services, up to 15 minutes	3	10	1,590	$80	$123.7K
T1027	Family training and counseling for child development, per 15 minutes	15	40	1,050	$40	$66.8K

Nearby Providers

Other providers in the same ZIP code as Affiliates Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bonneville School Dist #93	ID	Local Education Agency (LEA)	$0	$27.5M
Idaho Falls School District 91	ID	Local Education Agency (LEA)	$0	$11.2M
Transitions, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$7.8M
Innovative Health Care Concepts, Inc	ID	Case Manager/Care Coordinator	$0	$5.7M
Stewards Of Recovery	ID	Community/Behavioral Health Agency	$0	$5.1M
Joshua D. Smith Foundation	ID	Developmentally Disabled Services Day Training Agency	$0	$4.1M
See Opportunities And Achieve Results	ID	Case Management Agency	$0	$3.8M
Porter Eyecare PLLC	ID	Optometrist	$0	$3.1M
Denture Clinic Inc	ID	Dental Laboratory	$0	$3M
Childrens Supportive Services Incorporated	ID	Social Worker	$0	$3M

Affiliates Inc. — Billing Profile & Reimbursement Data

Sign up for Affiliates Inc. — Billing Profile & Reimbursement Data policy alerts

Affiliates Inc. — Billing Profile & Reimbursement Data

Sign up for Affiliates 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

Nearby Providers

Frequently Asked Questions

References