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

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

Denver Health And Hospital Authority (NPI 1992161780)

Field	Value
Entity Type	Organization
Organization	Denver Health And Hospital Authority
Address	1339 S Federal Blvd
City	Denver
State	CO
ZIP	80219
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 8, 2016

Payer Source	Total Paid
Medicaid	$29.4M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file while lifetime Medicaid revenue is $29.4M, indicating that Medicaid is the dominant and practically exclusive source of fee‑for‑service revenue for this entity. Analysts should treat Medicaid dynamics as the primary driver of financial and operational behavior for this provider.

Revenue is highly concentrated in a very small set of outpatient E/M codes: the precomputed top 3 Medicaid codes by revenue account for 83.8% of this provider's total Medicaid revenue, led by 99213 (54.0%) and 99214 (25.5%), with D0999 contributing 4.3%. This concentration signals that most Medicaid dollars flow through routine office/outpatient evaluation and management visits rather than procedure or specialty service lines.

The provider’s taxonomy as a Federally Qualified Health Center (FQHC), plus the presence of G0467 and high-volume E/M codes, points to a primary-care–centric, safety‑net clinic model. G0467 appears on the file (8.4K claims, ranks #7 of 107 in-state, 94th percentile), and preventive pediatrics codes (99391, 99393, 99394) are present, supporting a mixed primary care and pediatric preventive services footprint typical of FQHCs.

Competitive standing within Colorado is dominant for core E/M codes: 99213 ranks #6 of 2515 providers in-state (100th percentile; extreme outlier) and 99214 ranks #12 of 2632 providers in-state (100th percentile; extreme outlier), indicating the provider is a major statewide source of established‑patient office visits. By contrast, D0999 is mid‑range (rank #53 of 149, 65th percentile), so dominance is concentrated in standard outpatient E/M rather than ancillary procedure codes.

Several non‑E/M codes show unusually high relative volumes that could reflect programmatic services or bundled activities: 0012A ranks #2 of 337 providers in-state (100th percentile; extreme outlier) and 0011A ranks #1 of 359 (100th percentile; extreme outlier), while 36415 (47.9K claims) ranks #5 of 680 (99th percentile; notably above typical). These extreme and notable outlier labels suggest operational scale in specific, high‑frequency encounters beyond routine E/M.

The mix of 99213 (low‑level E/M) and substantial 99214 (moderate‑level E/M) revenue implies a patient population receiving frequent established‑patient care with a meaningful portion of visits requiring moderate medical decision making. Combined with preventive medicine codes and behavioral health services (90832, H0025, H0002), the clinical profile points to chronic disease management, preventive care, and integrated behavioral health within primary care workflows.

Tenure is established but relatively recent in NPI terms: the provider’s NPI was enumerated 2016-01-08 (~10 years ago), so this organization has roughly a decade of presence under this identifier. That duration is long enough to produce the large Medicaid volumes reported but still indicates a modern enrollment date versus legacy institutions.

From a payer and network‑planning perspective, this provider should be treated as a major Medicaid primary care access point in Colorado given $29.4M in Medicaid revenue and extreme statewide outlier rankings on 99213 and 99214. Its concentrated reliance on a few high‑volume E/M codes makes it a strategic node for Medicaid population health initiatives and contracting discussions focused on ambulatory primary care capacity.

Medicaid: Complete Services Breakdown

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

91 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…	147,060	$110	$15.6M
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…	61,440	$120	$7.4M
D0999	N/A	5,520	$230	$1.2M
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,…	9,870	$110	$1.1M
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	5,090	$130	$641.7K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,540	$90	$520.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	4,590	$80	$381.2K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	2,560	$130	$332.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,190	$100	$303.3K
0012A	N/A	4,320	$40	$164.2K

Showing 1–10 of 91

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Denver Health And Hospital Authority — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

91 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	53	150	2,140	$260	$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…	6	2,520	330	$100	$352K
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…	12	2,630	430	$90	$268.2K
H0025	Behavioral health prevention education service (delivery of services with target population to affect knowledge, attitude and/or behavior)	18	100	320	$80	$229.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	25	240	550	$110	$208.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22	260	380	$100	$161.6K
D2392	Post 2 surface resin‑based composite	271	690	290	$130	$148K
H0031	Mental health assessment, by non-physician	83	130	210	$140	$125K
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,…	18	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	26	290	160	$110	$111.1K

Showing 1–10 of 91

Related Providers

Other providers that share a Tax Identification Number (TIN) with Denver Health And Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Health And Hospital Authority	CO	General Practice Physician	$0	$95M
Denver Health And Hospital Authority	CO	General Acute Care Hospital	$0	$77.1M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$68.5M
Denver Health And Hospital Authority	CO	Ambulance	$3.4M	$46.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$40.3M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$28.2M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$25.5M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$17.4M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$15.2M
Denver Health And Hospital Authority	CO	Urgent Care Clinic/Center	$0	$12M

Nearby Providers

Other providers in the same ZIP code as Denver Health And Hospital Authority, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Zesty Enterprises LLC	CO	Developmentally Disabled Services Day Training Agency	$0	$55.1M
Angels Family LLC	CO	Foster Care Agency	$0	$18.7M
Comed Ventures LLC	CO	Durable Medical Equipment & Medical Supplies	$0	$11M
Savio House, Inc.	CO	Professional Counselor	$0	$10.4M
Family Medical Supply	CO	Durable Medical Equipment & Medical Supplies	$0	$10.1M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$8.1M
Denver Health And Hospital Authority	CO	Federally Qualified Health Center (FQHC)	$0	$6.9M
Antony Nguyen Vanbang	CO	General Practice Physician	$755.3K	$0
Advanced Rx LLC	CO	Community/Retail Pharmacy	$5.4K	$77.5K
Khoi Nguyen	CO	Family Medicine Physician	$64K	$0

Denver Health And Hospital Authority — 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