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

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

Rheumatology Associates P.A. (NPI 1003098252)

Rheumatology Associates P.A. is a specialist provider located in Portland, Maine. This profile covers 0 Medicare and 17 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Rheumatology Associates P.A.
Address	51 Sewall St
City	Portland
State	ME
ZIP	04102
Taxonomy	Specialist
NPI Enumerated	November 29, 2007

Payer Source	Total Paid
Medicaid	$381.2K
Medicare	$0

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,830	$50	$268.1K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	710	$50	$37.5K
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…	1,080	$30	$33.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	4,340	$1	$13K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	6,520	$1	$6.5K
84460	The lab analyst performs the technical lab test, typically using serum or plasma, to quantitate the enzyme alanine amino transferase, or ALT, also called SGPT, serum glutamate pyruvate transaminase.…	990	$1	$4K
82565	The lab analyst measures the amount of creatinine in a patient specimen, typically of blood. Creatinine is the waste material generated by the muscle tissue produced from the breakdown of creatine…	1,220	$1	$3.6K
86140	The lab analyst performs the technical lab test to analyze a specimen, typically serum, for the presence of C reactive protein.	1,130	$1	$3.4K
99204	The provider sees a new 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 provider…	40	$80	$3.4K
84450	The lab analyst performs the technical lab test, typically using serum or plasma, to quantitate the enzyme aspartate amino transferase, or AST, also called SGOT, serum glutamic oxaloacetic…	940	$1	$2.8K

Showing 1–10 of 17

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Maine Distribution

Rheumatology Associates P.A. — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	16	30	880	$110	$338.4K
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…	98	460	1,240	$30	$190K
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…	240	480	1,030	$20	$128.9K
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.	61	60	12,710	$1	$57.8K
99204	The provider sees a new 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 provider…	119	150	150	$60	$37.6K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	15	20	310	$40	$37K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	37	80	4,330	$1	$30.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	40	160	770	$1	$7.8K
86140	The lab analyst performs the technical lab test to analyze a specimen, typically serum, for the presence of C reactive protein.	33	40	3,860	$1	$6K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	51	60	270	$1	$1.9K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Shalom House, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$81.9M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M

Rheumatology Associates P.A. — Billing Profile & Reimbursement Data

Sign up for Rheumatology Associates P.A. — Billing Profile & Reimbursement Data policy alerts

Rheumatology Associates P.A. — Billing Profile & Reimbursement Data

Sign up for Rheumatology Associates P.A. — Billing Profile & Reimbursement Data policy alerts

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
Brian Daikh	ME	Specialist	$1.2M	$0
Kenneth Orourke	ME	Specialist	$381.7K	$0
Brian Keroack	ME	Specialist	$326.6K	$0
Edward Fels	ME	Specialist	$266.6K	$0
Joshua Keller	ME	Rheumatology Physician	$175K	$0
Stephanie Gartner-fanburg	ME	Rheumatology Physician	$98.5K	$0
Katherine Keller	ME	Specialist	$33.5K	$0