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

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

South East Alaska Regional Health Consortium (NPI 1942284765)

Key Findings

Field	Value
Entity Type	Organization
Organization	South East Alaska Regional Health Consortium
Address	1200 Salmon Creek Lane
City	Juneau
State	AK
ZIP	99801
Taxonomy	Clinic/Center
NPI Enumerated	December 5, 2005

Payer Source	Total Paid
Medicaid	$41M
Medicare	$0

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and total Medicaid revenue is $41M, indicating Medicaid is the principal — and for reporting purposes essentially the only — public payer driving its revenue base. The absence of Medicare billing magnifies the provider's financial sensitivity to Medicaid policy and reimbursement changes.

Revenue is highly concentrated in a very small set of services: the precomputed top three Medicaid codes (99213, 99214, 87635) account for 79.7% of the provider's total Medicaid revenue. That concentration implies material dependence on a narrow set of ambulatory and lab-testing activities for the majority of dollars.

99213 is the single largest revenue driver: 41.9K claims, $518 avg paid/claim, $21.7M revenue (53.3% of this provider's total Medicaid revenue). The code’s description (established patient office/outpatient E/M visits) together with its volume indicates the organization operates a high-volume ambulatory care practice handling large numbers of routine established-patient visits.

99214 is the second major driver with 15.3K claims, $539 avg paid/claim, $8.3M revenue (20.3% of Medicaid revenue). Its focus on moderate-level E/M visits (longer visits or higher decision-making) shows the provider delivers a substantial share of more complex outpatient management in addition to routine visits.

87635 (SARS–CoV–2 amplified nucleic acid testing) contributes 6.0% of Medicaid revenue with 6.1K claims, $403 avg paid/claim, and $2.5M revenue, and it ranks #11 of 96 providers in-state (89th percentile). This indicates on-site or closely affiliated COVID testing capacity that adds a meaningful ancillary revenue stream but is not the primary business line.

Competitive standing within the state is strong for core E/M services: 99213 ranks #8 of 485 providers in-state (99th percentile) and is described as notably above typical state volume, while 99214 ranks #15 of 440 (97th percentile) and is also notably above typical state volume. By contrast, 87635’s 89th percentile ranking and the descriptor of typical, unremarkable volume show the provider is a major player for outpatient E/M care but a more typical participant for COVID testing.

The broader code mix shows some service breadth beyond primary E/M: e.g., therapeutic exercise 97110 (2.9K claims, $278 avg, $793.1K revenue, 1.9% of Medicaid revenue) and ophthalmology 92014 (1.1K claims, $613 avg, $686.6K revenue, 1.7% of Medicaid revenue) indicate on-site rehab and eye care capabilities. Additional lines such as immunizations (90471, 2.8K claims, $201 avg, $565.8K revenue) and drug/toxicology screens (80306, 3.5K claims, $329 avg, $1.2M revenue) further suggest an integrated ambulatory clinic model offering preventive, diagnostic, and some ancillary services.

The provider has an established operating history: NPI enumerated on 2005-12-05 (~21 years ago), supporting the interpretation that the high-volume Medicaid patterns are the result of a long-standing regional care footprint. Given the concentrated revenue mix (79.7% from the top three codes) and long tenure, operational or reimbursement shifts affecting E/M visit billing would likely have outsized impact on the organization’s overall Medicaid revenue.

Medicaid: Complete Services Breakdown

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

72 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	41,890	$520	$21.7M
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…	15,340	$540	$8.3M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6,090	$400	$2.5M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	8,240	$150	$1.2M
80306	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by instrument–assisted direct optical observation, often utilizing immunoassay, to screen for any number of…	3,520	$330	$1.2M
0241U	N/A	1,780	$590	$1M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	2,850	$280	$793.1K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	1,120	$610	$686.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,820	$200	$565.8K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	750	$680	$508K

Showing 1–10 of 72

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

South East Alaska Regional Health Consortium — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

72 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2021	Community-based wrap-around services, per 15 minutes	68	80	1,070	$330	$1.3M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	11	100	360	$340	$1.2M
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…	8	490	680	$260	$1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	7	90	140	$230	$1M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	21	20	2,210	$160	$976.1K
S9484	Crisis intervention mental health services, per hour	31	40	500	$580	$844.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	30	70	570	$110	$829.4K
87086	Culture, bacterial; quantitative, colony count, urine.	17	20	2,570	$130	$803.5K
87081	The lab analyst cultures a patient specimen on a test medium designed to grow only a specific pathogenic organism.	12	20	720	$350	$661.5K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	82	120	970	$140	$652.1K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reach, Inc.	AK	Community/Behavioral Health Agency	$0	$52.8M
Bartlett Regional Hospital	AK	General Acute Care Hospital	$0	$29.5M
Jamhi Health & Wellness, Inc	AK	Community/Behavioral Health Agency	$0	$28.7M
Tides LLC	AK	Developmentally Disabled Services Day Training Agency	$0	$19.1M
Guardian Flight LLC	AK	Air Ambulance	$1.9M	$6.6M
Southeast Alaska Regional Health Constortium	AK	Clinic/Center	$0	$4.8M
One Source Home Care Services LLC	AK	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$4.7M
Bartlett Regional Hospital	AK	Community/Behavioral Health Agency	$0	$4.3M
Cornerstone Home Health, Inc.	AK	Supports Brokerage Agency	$0	$4M
Bartlett Regional Hospital	AK	Substance Abuse Rehabilitation Facility	$0	$3.1M

South East Alaska Regional Health Consortium — Billing Profile & Reimbursement Data

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South East Alaska Regional Health Consortium — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southeast Alaska Regional Health Consortium	AK	Critical Access Hospital	$0	$59.8M
Southeast Alaska Regional Health Consortium	AK	Community/Behavioral Health Agency	$0	$45M
Southeast Alaska Regional Health Consortium	AK	Community/Behavioral Health Agency	$0	$38.9M
Southeast Alaska Regional Health Consortium	AK	Federally Qualified Health Center (FQHC)	$0	$19.9M
Southeast Alaska Regional Health Consortium	AK	Community/Behavioral Health Agency	$0	$18.9M
South East Alaska Regional Health Consortium	AK	General Practice Dentistry	$0	$12.2M
South East Alaska Regional Health Consortium	AK	Clinic/Center	$0	$8.3M
Southeast Alaska Regional Health Consortium	AK	General Practice Dentistry	$0	$8M
Southeast Alaska Regional Health Consortium	AK	Community/Behavioral Health Agency	$0	$5.3M
South East Alaska Regional Health Consortium	AK	Clinic/Center	$0	$5M