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

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

Spero Health Of Kentucky, LLC (NPI 1982102109)

Field	Value
Entity Type	Organization
Organization	Spero Health Of Kentucky, LLC
Address	106 Belinda Blvd Ste 100
City	Danville
State	KY
ZIP	40422
Taxonomy	Addiction Medicine (Family Medicine) Physician
NPI Enumerated	January 23, 2018

Payer Source	Total Paid
Medicaid	$154.3M
Medicare	$0

Key Findings

SPERO HEALTH OF KENTUCKY, LLC is effectively a Medicaid-centric provider with no Medicare billing on file and $154.3M in lifetime Medicaid revenue, indicating its operations and revenue are overwhelmingly dependent on Medicaid as the single payer source represented in claims data. The absence of Medicare billing makes this an effectively single-payer profile in available datasets and should shape payer contracting and network analyses accordingly.

Revenue is highly concentrated among a few high-volume Medicaid codes: the top three Medicaid codes by revenue account for 46.8% of the provider's total Medicaid revenue. The leading contributors among these are lab and drug-testing codes (80307, G0480/G0482) and case management (T2023), which together form a substantial portion of the practice’s Medicaid-derived income and point to focused service lines.

The code mix indicates a service model centered on addiction/substance-use care and associated laboratory testing. High revenue and claim counts for 80307 ($34.2M), G0480 ($17.5M), G0482 ($17.9M), and related definitive testing codes (G0481, G0483) show heavy investment in both presumptive and definitive drug testing, while behavioral health and substance use treatment codes such as T2023 ($17.2M), T1007 ($7M), H0047 ($5.5M), and group/individual psychotherapy codes (90853, 90832) reflect integrated treatment and case-management services.

SPERO HEALTH is a dominant statewide player for multiple Medicaid codes based on rank and percentile. The provider ranks #1 for G0480 and T1007 and #2 for 80307 and G0482 in Kentucky, often at the 100th percentile or near it; these rankings and the platform’s “extreme outlier” or “notably above typical” labels indicate volumes far above typical state peers and suggest market leadership in drug testing and substance-use treatment services in Kentucky.

Several specific codes show extreme-volume outlier status relative to in-state peers, signaling concentrated operational scale: 80307 is labeled an "extreme outlier" with $34.2M revenue and ranks #2 of 342, 99213 is an "extreme outlier" with $20M and ranks #5, and G0480 is an "extreme outlier" at $17.5M and the state #1. These statistical outlier designations reinforce that the provider’s patient encounters and testing throughput are unusually large compared with other Kentucky providers.

The operational footprint mixes high-volume low-unit-payment services and higher-paid diagnostic testing. For example, 90853 (group psychotherapy) shows 481.7K claims at $12 avg paid/claim generating $5.8M, reflecting heavy utilization of group-based, lower-rate behavioral services, whereas definitive testing codes like G0482 pay higher per-claim rates (e.g., $136 avg for G0482) and collectively contribute tens of millions in revenue despite fewer claims. This combination suggests a high-throughput model pairing frequent outpatient visits and group sessions with centralized laboratory testing.

Clinical service intensity includes both brief and extended encounters: E/M codes 99213 (426.6K claims, $20M) and 99214 (129K claims, $7.6M) are major contributors, indicating a large volume of established-patient office visits at varying complexity levels supporting ongoing treatment management. The presence of G2087 (office-based treatment for opioid use disorder, $1.7M) and psychotherapy codes (90832, 90837) further confirms longitudinal behavioral health and medication-assisted treatment components in care delivery.

The practice has an established presence in federal enrollment data, with its NPI enumerated on 2018-01-23 (~8 years ago), which provides multi-year continuity for the high volumes observed. This tenure combined with sustained, outsized volumes on multiple Medicaid codes suggests an enduring operational scale rather than a short-term spike in activity.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	728,350	$50	$34.2M
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…	426,560	$50	$20M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	131,840	$140	$17.9M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	218,550	$80	$17.5M
T2023	Targeted case management; per month	58,990	$290	$17.2M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	51,870	$160	$8.1M
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…	129,000	$60	$7.6M
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	112,520	$60	$7M
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…	481,730	$10	$5.8M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	12,560	$430	$5.5M

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Spero Health Of Kentucky, LLC — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G2087	Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month	2	10	460	$480	$2.8M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	7	70	1,650	$100	$2M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	2	50	2,830	$90	$1.4M
H0047	Alcohol and/or other drug abuse services, not otherwise specified	2	10	2,090	$180	$1.3M
T2023	Targeted case management; per month	5	530	530	$300	$1.1M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	5	80	990	$60	$912.2K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	179	230	1,750	$110	$793.5K
H0038	Self‑help/peer services, per 15 minutes	52	320	3,070	$50	$678.3K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	2	340	2,700	$40	$673.3K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	1	140	2,000	$60	$639.8K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Spero Health Of Kentucky, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Addixxion Recovery Of Kentucky, LLC	KY	Addiction Medicine (Family Medicine) Physician	$0	$16.6M
Thomas Karelis	KY	Internal Medicine Physician	$188.5K	$1M
Esther Mwasumbi	KY	Family Nurse Practitioner	$41.7K	$0
Heather Thompson	KY	Family Nurse Practitioner	$25.2K	$0
Chasity King	KY	Family Nurse Practitioner	$15.8K	$0
Kellie Smith	KY	Family Nurse Practitioner	$11.7K	$0
Aaron Ferda	KY	Addiction Medicine (Preventive Medicine) Physician	$9.9K	$1.1K
Jerry Ward	KY	Clinical Social Worker	$1K	$2.4K

Nearby Providers

Other providers in the same ZIP code as Spero Health Of Kentucky, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ephraim Mcdowell Regional Medical Center Incorporated	KY	General Acute Care Hospital	$0	$60M
G & R Staed, Inc	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$12M
D&s Residential Services, LP	KY	Developmental Disabilities Clinic/Center	$0	$9.8M
Family Ties, LLC	KY	Developmentally Disabled Services Day Training Agency	$0	$8.7M
Empact Midwest LLC	KY	Emergency Medicine Physician	$0	$7.3M
A1 Case Management	KY	Case Management Agency	$0	$7.1M
Danville Pediatrics And Primary Care, PLLC	KY	Pediatrics Physician	$0	$5.9M
Ekkco Inc.	KY	Adult Care Home Facility	$0	$5.5M
Ich-epg Alliance, LLC	KY	Emergency Medicine Physician	$0	$4.8M
Kentucky Counseling Associates, LLC	KY	Professional Counselor	$0	$4.3M

Spero Health Of Kentucky, LLC — Billing Profile & Reimbursement Data

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Spero Health Of Kentucky, LLC — 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