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

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

Pcc Community Wellness Center (NPI 1871516799)

Field	Value
Entity Type	Organization
Organization	Pcc Community Wellness Center
Address	14 Lake St
City	Oak Park
State	IL
ZIP	60302
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$102.1M
Medicare	$0

Key Findings

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes account for 99.0% of this provider's total Medicaid revenue, led by T1015 at $99.2M (97.3% of this provider's total Medicaid revenue), followed by T1040 at $1.2M (1.2%) and D0999 at $561.2K (0.5%). This concentration indicates the business is overwhelmingly dependent on a very small set of Medicaid reimbursement streams.

The provider’s taxonomy as a Federally Qualified Health Center (FQHC) and the dominance of T1015 (T1015 – Clinic visit/encounter, all-inclusive) indicate an FQHC-style bundled clinic visit model where a single all-inclusive visit code drives most clinical revenue; the presence of T1040 (Medicaid certified community behavioral health clinic services, per diem) further shows integrated behavioral health services are a formal part of the operation. Together these codes suggest the organization operates as a comprehensive community clinic that bills bundled visit and per-diem behavioral health services rather than fee-for-service specialty care.

Payer mix is effectively single-payer Medicaid: there is no Medicare billing on file while Medicaid revenue totals $102.1M, so the provider’s financial exposure and operational orientation appear concentrated in the Medicaid population rather than a split Medicare/Medicaid practice. This single-payer dependence should be considered when assessing reimbursement risk or contracting strategies.

Competitive standing for the dominant clinic code is exceptional: T1015 ranks #3 of 846 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), reflecting a statewide-scale presence for bundled clinic visits and suggesting the provider is a major node in the state’s FQHC network for routine ambulatory care. This rank supports the interpretation that the organization is a leading Medicaid clinic volume generator in Illinois.

Behavioral health per-diem services are also a major line: T1040 ranks #2 of 191 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), indicating a top-tier Medicaid behavioral health footprint in the state. By contrast, D0999 (no description available) is ranked #66 of 219 (70th percentile; typical, unremarkable volume), showing that not all secondary codes contribute at the same relative scale.

The provider reports very high immunization and injection volumes across multiple codes, with several vaccine-related codes marked as extreme outliers statewide (examples include 90651: 12.3K claims, $73.8K revenue, ranks #2 of 773 providers in-state (100th percentile; extreme outlier); 90686: 36K claims, $36K revenue, ranks #3 of 2637 providers in-state (100th percentile; extreme outlier); and 96372: 24.4K claims, $24.4K revenue, ranks #2 of 900 providers in-state (100th percentile; extreme outlier)). These patterns indicate a large immunization/pediatric preventive services throughput in addition to primary care visits.

Reproductive and maternal services appear as meaningful secondary lines: J7307 (etonogestrel implant) yields $260.7K revenue (550 claims) and ranks #3 of 36 providers in-state (94th percentile; typical, unremarkable volume), while 59409 (hospital admission for delivery) accounts for $249.7K (275 claims) and ranks #26 of 174 providers in-state (86th percentile; typical, unremarkable volume). These data points suggest the clinic provides family-planning and some maternity-related services alongside core primary care and behavioral health.

The NPI was enumerated 2006-07-25 (~20 years ago), indicating long tenure as an enrolled provider; combined with FQHC taxonomy and the $102.1M Medicaid lifetime revenue, the data portray an established, long-standing community health center operation focused on Medicaid populations. This longevity aligns with the high-volume statewide rankings observed for multiple Medicaid codes.

Medicaid: Complete Services Breakdown

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

189 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	746,210	$130	$99.2M
T1040	Medicaid certified community behavioral health clinic services, per diem	18,050	$70	$1.2M
D0999	N/A	5,010	$110	$561.2K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	550	$470	$260.7K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	280	$910	$249.7K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	12,300	$10	$73.8K
J1050	Injection, medroxyprogesterone acetate, 1 mg	5,150	$10	$61.8K
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	180	$320	$56.8K
90715	The provider uses this combination vaccine as a booster to help protect patients who are 7 years old or older from lockjaw, diphtheria, and whooping cough.	13,890	$1	$41.7K
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…	36,050	$1	$36K

Showing 1–10 of 189

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Pcc Community Wellness Center — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

189 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	850	7,490	$120	$3.9M
D0999	N/A	66	220	1,090	$110	$610.1K
J7298	Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg	4	10	120	$830	$372.2K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	26	170	50	$910	$144.1K
T1040	Medicaid certified community behavioral health clinic services, per diem	2	190	880	$70	$128.2K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	3	40	20	$630	$97.6K
D1120	Prophylaxis–child	611	2,140	960	$40	$89.1K
D1351	Sealant - per tooth	480	1,270	530	$60	$87.1K
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…	71	760	140	$110	$67.3K
D0120	Periodic oral evaluation - established patient	718	2,170	1,010	$30	$64.3K

Showing 1–10 of 189

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pcc Community Wellness Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Enrique Calderon	NC	Ophthalmology Physician	$713K	$0
Veronica Pappas	IL	Family Nurse Practitioner	$45.3K	$35K
Jennifer Rossato	IL	Family Medicine Physician	$7.5K	$24.9K

Nearby Providers

Other providers in the same ZIP code as Pcc Community Wellness Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thrive Counseling Center	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.5M
Randall Mcgivney	IL	Clinical Pathology/Laboratory Medicine Physician	$27.6K	$4.1M
Unilab Inc	IL	Clinical Medical Laboratory	$2.9M	$1M
Sabrina Albert	IL	Clinical Social Worker	$0	$3.1M
Timothy Mccarthy	IL	Ophthalmology Physician	$151.5K	$2.3M
Mark Balek	IL	Cardiovascular Disease Physician	$1.1M	$516.2K
Dheeraj Mahajan	IL	Internal Medicine Physician	$518.5K	$958K
Kamran Heydarpour	IL	Gastroenterology Physician	$129.5K	$1.2M
David Springer	IL	Ophthalmology Physician	$429.9K	$174.1K
Victoria Chirman	IL	Podiatrist	$473.7K	$20K

Pcc Community Wellness Center — Billing Profile & Reimbursement Data

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Pcc Community Wellness Center — 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