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

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

Advocates For A Healthy Community, Inc. (NPI 1861590861)

Advocates For A Healthy Community, Inc. is a federally qualified health center (fqhc) provider located in Springfield, Missouri. This profile covers 0 Medicare and 34 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	Advocates For A Healthy Community, Inc.
Address	618 N Benton Ave
City	Springfield
State	MO
ZIP	65806
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

34 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…	26,210	$90	$2.3M
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…	14,640	$60	$805.1K
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…	5,660	$30	$152.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	650	$150	$99.9K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	520	$150	$75.7K
99203	The provider sees a new 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 provider…	670	$80	$51.7K
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…	870	$50	$40.7K
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…	440	$50	$21.5K
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…	300	$70	$21.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	310	$50	$14.8K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Advocates For A Healthy Community, Inc. — 3 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	38	3,170	230	$70	$128.1K
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…	109	200	510	$20	$120.4K
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…	104	4,310	300	$60	$110.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	68	420	90	$100	$60.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	49	190	90	$90	$59.8K
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…	483	1,060	250	$40	$57.7K
99204	The provider sees a new 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 provider…	253	580	60	$110	$42K
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…	74	390	170	$20	$39.5K
99203	The provider sees a new 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 provider…	98	860	60	$70	$33.9K
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…	4	120	620	$20	$33.6K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Advocates For A Healthy Community Inc	MO	Federally Qualified Health Center (FQHC)	$0	$23.2M
Lester E Cox Medical Centers	MO	General Practice Physician	$0	$9.2M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$4.9M
Advocates For A Healthy Community, Inc.	MO	Federally Qualified Health Center (FQHC)	$0	$3.8M
Ronald Pritchard	OK	Diagnostic Radiology Physician	$166.5K	$5K
Patrick Cabrera	MO	Diagnostic Radiology Physician	$94.5K	$11.7K
David Owens	GA	Diagnostic Radiology Physician	$86.3K	$230
Jose Padilla	MO	Surgery Physician	$34.6K	$0
Angela Limpus	MO	Nurse Practitioner	$31.8K	$2K
Louis Delcampo	MO	Anesthesiology Physician	$7.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
K And C Stepping Stones, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$54M
K And C Stepping Stones, LLC	MO	Personal Care Attendant	$0	$6.9M
Ashley Popejoy	MO	Pediatric Dentistry	$0	$5.3M
Great Circle	MO	Psychiatric Residential Treatment Facility	$0	$3.8M
Sarah Young	MO	Medical Physician Assistant	$101.6K	$0
Kia Washington	MO	Women's Health Nurse Practitioner	$130	$42.9K

Advocates For A Healthy Community, Inc. — Billing Profile & Reimbursement Data

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Advocates For A Healthy Community, Inc. — 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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