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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Codac Inc (NPI 1851513394)

Field	Value
Entity Type	Organization
Organization	Codac Inc
Address	1052 Park Ave
City	Cranston
State	RI
ZIP	02910
Taxonomy	Substance Use Disorder Rehabilitation Clinic/Center
NPI Enumerated	May 3, 2007

Payer Source	Total Paid
Medicaid	$54.3M
Medicare	$0

Key Findings

CODAC INC is effectively a Medicaid-only provider: it reports no Medicare billing on file and $54.3M in lifetime Medicaid revenue, making Medicaid the sole payer driving measurable billed revenue for this entity. This single-payer profile limits any meaningful Medicare vs. Medicaid payer-mix analysis and positions the organization as focused on publicly funded behavioral health reimbursement.

Revenue is highly concentrated in a very small set of service codes: the precomputed top 3 Medicaid codes by revenue account for 97.3% of the provider's total Medicaid revenue. In particular, H0020 represents 68.5% of Medicaid revenue and H0047 represents 26.0%, together comprising the vast majority of billed Medicaid dollars for this provider.

The service mix and high-weighted codes are consistent with an opioid treatment and substance-use services operation: H0020 (methadone administration) is the single largest revenue driver at $37.2M and 422.9K claims, which aligns with an opioid treatment program model that dispenses medication on-site. H0047 (alcohol and/or other drug abuse services, not otherwise specified) contributes $14.1M and 63.4K claims, suggesting a large volume of non-specific AOD services or bundled counseling/intervention visits.

CODAC is a dominant statewide participant on several key SUD codes: H0047 ranks #1 of 22 providers in-state at the 100th percentile and is labeled an extreme outlier, indicating the provider bills far more for that code than typical state peers. H0020 ranks #3 of 31 providers at the 93th percentile (notably above typical state volume), and H0025 ranks #1 of 6 providers at the 100th percentile (notably above typical state volume), together showing market leadership on both medication and prevention/education services.

Operationally, the presence of medication-assisted-treatment codes beyond methadone—J0574 (25.5K claims, $636.4K revenue) and J0572 (657 claims, $28.3K revenue)—indicates CODAC also bills for buprenorphine/naloxone products, though these represent a much smaller share of revenue. This mix suggests the clinic provides multiple pharmacotherapy modalities (methadone-dominant with supplemental buprenorphine dispensing) alongside counseling and therapy.

The provider reports very large volumes of some non-revenue Medicaid codes that may reflect care-management or reporting practices: H0006 shows 158.3K claims with $0 avg paid/claim and $0 revenue and ranks #1 of 27 providers (100th percentile, extreme outlier); H0036 shows 35.8K claims with $0 avg paid/claim and $0 revenue and ranks #8 of 89 providers (92th percentile). These patterns indicate high documented activity in case management and community psychiatric supportive treatment units but no corresponding paid dollars in the dataset, which is important for interpreting apparent service volumes vs. reimbursed revenue.

Clinical psychotherapy and outpatient E/M are also in the claim mix but are much smaller revenue contributors: 90837 (5.9K claims, $474.3K revenue) ranks #14 of 358 providers (96th percentile, notably above typical state volume) and 90834/90832 and 99214/99213 appear at typical to above-typical volumes for the state. This signals that CODAC augments medication treatment with individual and group psychotherapy services rather than operating solely as a dispensing clinic.

CODAC's NPI tenure (~19 years ago, enumerated 2007-05-03) indicates a long-established presence in the Rhode Island behavioral health market, which—combined with its top-state rankings on multiple SUD codes—supports a conclusion that the provider is an established, high-volume Medicaid-focused SUD treatment center in-state.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	422,860	$90	$37.2M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	63,380	$220	$14.1M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	7,630	$200	$1.5M
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	25,450	$30	$636.4K
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…	5,860	$80	$474.3K
H0022	Alcohol and/or drug intervention service (planned facilitation)	780	$150	$113.9K
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…	860	$80	$65.7K
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…	1,160	$50	$54.6K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	980	$40	$39.2K
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…	860	$40	$35.9K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Codac Inc — 5 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	3	30	12,240	$50	$3.9M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	1	20	1,280	$220	$1.6M
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	1	10	760	$260	$510K
J0574	Buprenorphine/naloxone, oral, greater than 6 mg, but less than or equal to 10 mg buprenorphine	1	10	1,620	$20	$217.8K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	8	90	510	$10	$187.5K
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…	228	750	330	$70	$92.5K
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…	14	360	280	$90	$86.4K
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…	300	1,730	220	$70	$75.2K
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…	948	2,050	300	$50	$72.3K
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…	44	190	270	$40	$51K

Showing 1–10 of 15

Related Providers

Other providers that share a Tax Identification Number (TIN) with Codac Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Codac Inc	RI	Methadone Clinic	$206.4K	$2.7M
Catherine Degood	RI	Addiction Medicine (Family Medicine) Physician	$3.1K	$1.1M
Codac Inc	RI	Methadone Clinic	$91.7K	$352.6K
Codac Inc	RI	Methadone Clinic	$55.6K	$194.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joy Home Care Inc.	RI	Home Health Agency	$0	$75.4M
Hope Nursing Home Care, LLC	RI	Home Health Agency	$0	$70.6M
Spurwink Ri	RI	Developmentally Disabled Services Day Training Agency	$0	$39.1M
Alee Behavioral Healthcare	RI	Behavior Analyst	$0	$22M
Homecare Advantage Inc.	RI	Nursing Care Agency	$0	$12.9M
Ocean State Dental Group Inc	RI	Dentist	$0	$7.9M
Home Care Networks, LLC	RI	Home Health Aide	$0	$5.7M
Park Avenue Senior Care, Inc	RI	Adult Day Care Clinic/Center	$0	$3M
Cranston Public Schools	RI	Local Education Agency (LEA)	$0	$2.7M
City Of Cranston	RI	Land Ambulance	$573.8K	$1.8M

Codac 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