Metro Community Provider Network INC
Metro Community Provider Network INC was paid $3.14M by Medicaid between Jan 2018 and Aug 2023, across 34 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 67% of everything it billed.
LAKEWOOD, CO 80228
Next to other Federally Qualified Health Center (FQHC) providers in Colorado
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 8,351 | $715K | |
| 2019 | 6,678 | $585K | |
| 2020 | 914 | $95K | |
| 2021 | 4,369 | $526K | |
| 2022 | 5,600 | $738K | |
| 2023 | 3,434 | $484K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 67% | 13,222 | 10,416 | $2.10M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 18% | 3,446 | 3,040 | $558K |
| H0002 | Behavioral health screening to determine eligibility for admission to treatment program | 5.2% | 1,322 | 798 | $164K |
| H0031 | Mental health assessment, by non-physician | 3.4% | 906 | 563 | $107K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.3% | 381 | 365 | $73K |
| G0467 | Community health center visit, returning patientFederally 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 time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 2.2% | 2,474 | 1,839 | $69K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.3% | 255 | 210 | $41K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,165 | 1,068 | $24K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 29 | 28 | $6K |
| 0124A | <1% | 17 | 16 | $247.08 | |
| 90677 | <1% | 14 | 14 | $56.03 | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 814 | 750 | $4.08 |
22 more codes
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | <1% | 81 | $0.38 |
| 90686 | <1% | 380 | $0.02 | |
| 90715 | 0% | 15 | $0.00 | |
| 81002 | 0% | 95 | $0.00 | |
| 80061 | Lipid panel | 0% | 138 | $0.00 |
| 82948 | 0% | 546 | $0.00 | |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 25 | $0.00 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 804 | $0.00 |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 349 | $0.00 |
| 80053 | Comprehensive metabolic panel | 0% | 1,043 | $0.00 |
| 36416 | 0% | 857 | $0.00 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 225 | $0.00 |
| 82607 | 0% | 140 | $0.00 | |
| 87086 | Culture, bacterial; quantitative colony count, urine | 0% | 15 | $0.00 |
| 90688 | 0% | 248 | $0.00 | |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 61 | $0.00 |
| 36415 | Collection of venous blood by venipuncture | 0% | 95 | $0.00 |
| 99000 | 0% | 107 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 15 | $0.00 |
| 87800 | 0% | 12 | $0.00 | |
| 82962 | 0% | 29 | $0.00 | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 21 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Metro Community Provider Network INC | Aurora, CO | $25.62M |
| Metro Community Provider Network INC | Wheat Ridge, CO | $23.59M |
| Metro Community Provider Network INC | Aurora, CO | $11.08M |
| Metro Community Provider Network, INC. | Aurora, CO | $9.74M |
| Metro Community Provider Network INC | Arvada, CO | $9.29M |
| Metro Community Provider Network INC | Parker, CO | $3.84M |
| Metro Community Provider Network, INC. | Englewood, CO | $3.24M |
| Metro Community Provider Network INC | Aurora, CO | $1.35M |
| Metro Community Provider Network, INC. | Aurora, CO | $928K |
| Metro Community Provider Network INC | Lakewood, CO | $865K |
| Metro Community Provider Network, INC. | Lakewood, CO | $560K |
| Metro Community Provider Network INC | Aurora, CO | $468K |
| Metro Community Provider Network, INC. | Golden, CO | $464K |
| Metro Community Provider Network INC | Aurora, CO | $358K |
| Metro Community Provider Network INC | Conifer, CO | $241K |
| Metro Community Provider Network INC | Aurora, CO | $59K |
| Metro Community Provider Network, INC. | Aurora, CO | $49K |
| Metro Community Provider Network INC | Wheat Ridge, CO | $4K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.