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

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

Centro De Salud De La Comunidad De San Ysidro, Inc. (NPI 1952364747)

Field	Value
Entity Type	Organization
Organization	Centro De Salud De La Comunidad De San Ysidro, Inc.
Address	4004 Beyer Blvd
City	San Ysidro
State	CA
ZIP	92173
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	April 11, 2006

Payer Source	Total Paid
Medicaid	$157M
Medicare	$0

Key Findings

CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file while total Medicaid revenue is $157M, indicating a single-payer operational footprint at scale. The provider’s NPI was enumerated on 2006-04-11 (~20 years ago), showing long tenure in the market as an FQHC.

Revenue is highly concentrated: the top three Medicaid revenue drivers (T1015, 00003, and G9012) together account for 97.9% of the provider’s total Medicaid revenue. Individually, T1015 contributes $83.3M (53.1% of Medicaid revenue), 00003 contributes $63.3M (40.4%), and G9012 contributes $6.8M (4.4%), so a very small set of codes dominate financial performance.

The code mix and FQHC taxonomy support a community clinic operating model: T1015 (Clinic visit/encounter, all-inclusive) is the single largest revenue source with 392.7K claims and $212 avg paid/claim, and the presence of G0467 (14K claims, $17 avg paid/claim) corroborates federally qualified health center–style bundled visit billing. This combination suggests day-to-day operations are driven by high-volume, bundled primary-care visits rather than specialty or high-acuity procedures.

One top driver is opaque in description but large in impact: 00003 (no description available) generated 238K claims and $63.3M in revenue and ranks #4 in-state, marked as an extreme outlier. Because 00003 represents 40.4% of Medicaid revenue but lacks a description in the dataset, analysts should prioritize mapping this code to a program or bundled payment category for accurate service-line attribution and contract negotiations.

Competitive standing in-state is very strong on several codes: T1015 ranks #33 of 1550 providers (98th percentile; extreme outlier) and 00003 ranks #4 of 688 (100th percentile; extreme outlier), indicating the organization is a dominant volume provider statewide for its primary visit/bundle codes. G9012 (case management) ranks #16 of 718 (98th percentile; notably above typical state volume), signaling above-average capacity in case management services relative to peers.

Although many standard E/M codes (for example 99213 with 460.9K claims, 99214 with 207.8K claims, and 99212 with 214.8K claims) show exceptionally high claim volumes and high in-state ranks (100th percentile or near), these codes generate relatively modest revenue because the avg paid/claim for those entries is reported at $1–$2. This pattern indicates extremely high visit counts with low per-claim reimbursement, consistent with a high-throughput community clinic model where bundled FQHC/encounter codes capture most payment.

Service-line nuance: G9012 (Other specified case management) and G9008 (Coordinated care fee) together point to a substantive care-management capability; G9012 produced $6.8M (4.4% of Medicaid revenue) and ranks high in-state, while G9008 generated $375.9K and ranks at a typical level. These case-management and coordination codes suggest the clinic provides non-visit, population-health functions in addition to face-to-face encounters, aligning with FQHC responsibilities for comprehensive community care.

Concentration risk and operational implications are material: with T1015 and 00003 comprising 53.1% and 40.4% of Medicaid revenue respectively, payer negotiations, program changes, or coding reclassifications for these specific codes would have outsized impact on the provider’s financials. Analysts should treat revenue exposure to these few codes as a primary sensitivity when modeling reimbursement scenarios or assessing competitive threats within California.

Medicaid: Complete Services Breakdown

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

249 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	392,700	$210	$83.3M
00003	N/A	237,980	$270	$63.3M
G9012	Other specified case management service not elsewhere classified	55,950	$120	$6.8M
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…	460,910	$1	$460.9K
G9920	Screening performed and negative	27,690	$20	$443.1K
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…	207,780	$1	$415.6K
G9008	Coordinated care fee, physician coordinated care oversight services	2,630	$140	$375.9K
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…	5,680	$50	$255.5K
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…	14,030	$20	$238.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	214,800	$1	$214.8K

Showing 1–10 of 249

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Centro De Salud De La Comunidad De San Ysidro, Inc. — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

249 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	33	1,550	38,050	$190	$14.1M
00003	N/A	4	690	14,940	$260	$7.7M
G9012	Other specified case management service not elsewhere classified	16	720	1,110	$110	$651.3K
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…	2,042	4,290	780	$140	$400.1K
G9008	Coordinated care fee, physician coordinated care oversight services	154	490	660	$70	$396.7K
95144	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more single dose vials.	80	110	1,020	$100	$391.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	255	280	730	$90	$315.5K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	268	290	500	$110	$275.6K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	292	390	250	$200	$220.4K
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…	54	1,030	1,050	$70	$219.7K

Showing 1–10 of 249

Related Providers

Other providers that share a Tax Identification Number (TIN) with Centro De Salud De La Comunidad De San Ysidro, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$121.2M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$69.5M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$64.2M
Centro De Salud De La Comunidad De San Ysidro Inc	CA	Federally Qualified Health Center (FQHC)	$0	$37.3M
Centro De Salud De La Comunidad De San Ysidro Inc	CA	Federally Qualified Health Center (FQHC)	$0	$33.6M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$28.4M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Federally Qualified Health Center (FQHC)	$0	$24.1M
Mehran Moussavian	CA	Interventional Cardiology Physician	$3M	$67.3K
Hassan Kafri	CA	Cardiovascular Disease Physician	$945.1K	$6.5K
Georgios Papastergiou	CA	Retina Specialist (Ophthalmology) Physician	$523K	$0

Centro De Salud De La Comunidad De San Ysidro, Inc. — Billing Profile & Reimbursement Data

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Centro De Salud De La Comunidad De San Ysidro, 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

Frequently Asked Questions

References