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

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

Erie County Care Management (NPI 1902023005)

Field	Value
Entity Type	Organization
Organization	Erie County Care Management
Address	155 W 8th St
City	Erie
State	PA
ZIP	16501
Taxonomy	Case Management Agency
NPI Enumerated	April 19, 2007

Payer Source	Total Paid
Medicaid	$43.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and $43.5M in lifetime Medicaid revenue, so the available billing record is effectively single-payer (Medicaid) rather than balanced between Medicare and Medicaid. The absence of Medicare claims means national Medicare peer comparisons are not applicable for this entity.

Revenue is highly concentrated: the precomputed top-3 Medicaid codes account for 100.0% of the provider's Medicaid revenue, with W7210 representing 68.7% of Medicaid revenue ($29.9M) and T1017 representing 31.3% of Medicaid revenue ($13.6M). This two-code split dominates the provider’s entire reported Medicaid book of business.

The provider’s taxonomy is Case Management Agency and the reported mix supports that service line: T1017 is explicitly T1017 – Targeted case management, each 15 minutes, which aligns with time-based, client-centered case management delivery. W7210 lacks a description in the file, but its very large revenue share suggests it is likewise a core, billable component of the agency’s case management or state-specific care coordination workflow.

Operational scale is substantial: the top Medicaid codes show 324.9K claims for W7210 (average paid $92 per claim) and 135K claims for T1017 (average paid $101 per claim), indicating high transaction volumes and an operational model that processes large numbers of short-duration, time-based case management transactions. The average-paid-per-claim figures are consistent with frequent, incremental service units rather than single high-dollar procedures.

Competitive standing on W7210: the provider ranks #5 of 69 in-state (94th percentile) for this code, placing it among the top in-state billers by rank, yet the data source characterizes the volume for W7210 as "typical, unremarkable volume for this code," suggesting the provider’s high rank does not reflect an unusual intensity relative to state norms for that particular code.

Competitive standing on T1017: the provider ranks #5 of 205 in-state (98th percentile) for T1017, and the source labels this as "notably above typical state volume for this code," indicating the provider is a major in-state player for targeted case management and has significantly higher utilization of T1017 than most peers. This supports the view that targeted case management is a primary competitive focus.

The provider has a long tenure on file, with NPI enumeration dated 2007-04-19 (~19 years ago), which combined with concentrated, high-volume Medicaid billing suggests an established, Medicaid-focused case management operation that has maintained sustained service delivery at scale over many years.

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
W7210	N/A	324,860	$90	$29.9M
T1017	Targeted case management, each 15 minutes	135,000	$100	$13.6M

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Erie County Care Management — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W7210	N/A	5	70	83,330	$80	$10M
T1017	Targeted case management, each 15 minutes	5	210	18,200	$100	$2.9M

Nearby Providers

Other providers in the same ZIP code as Erie County Care Management, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Clinical Laboratories	PA	Clinical Medical Laboratory	$3.8M	$25.9M
New Directions Healthcare LLC	PA	Methadone Clinic	$83.3K	$14.2M
Community Health Net	PA	Federally Qualified Health Center (FQHC)	$0	$7.2M
Erie County Care Management	PA	Case Management Agency	$0	$5.5M
Luis Aparicio	PA	Endocrinology, Diabetes & Metabolism Physician	$44.2K	$644.9K
Nicholas Sala	PA	Ophthalmology Physician	$17.5K	$549.2K
Michelle Mioduszewski	PA	Occupational Therapist	$102.1K	$0
Baron Denniston	PA	Psychiatry Physician	$25.6K	$0

Erie County Care Management — Billing Profile & Reimbursement Data

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Erie County Care Management — Billing Profile & Reimbursement Data

Sign up for Erie County Care Management — 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