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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Stanley Balon (NPI 1003860172)

Field	Value
Entity Type	Individual
Organization	Stanley Balon
Address	20 Cumberland Hill Rd Unit 202
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 21, 2006

Payer Source	Total Paid
Medicare	$75.8K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

9 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…	370	$90	$34.7K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	110	$130	$14.9K
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	80	$170	$14.1K
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…	130	$70	$8.4K
G0008	Administration of influenza virus vaccine	60	$30	$1.8K
G0009	Administration of pneumococcal vaccine	20	$30	$630
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	40	$10	$500
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,…	10	$40	$500
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	20	$1	$60

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Rhode Island Distribution

Stanley Balon — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	174	1,950	100	$80	$11.7K
G0439	103	450	60	$100	$7.7K
99213	579	1,950	70	$60	$7.4K
G0438	2	40	20	$150	$4.5K
G0008	126	420	30	$30	$2.5K
99212	350	370	30	$40	$2.2K
93000	154	380	30	$10	$810
G0009	93	210	20	$30	$660
96127	19	40	20	$1	$110

Related Providers

Other providers that share a Tax Identification Number (TIN) with Stanley Balon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prime Healthcare Services Landmark LLC	RI	General Acute Care Hospital	$0	$26.2M
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Richard Lim	RI	Internal Medicine Physician	$52.2K	$3.4M
David Stoll	RI	Hematology & Oncology Physician	$22.4K	$1.4M
Prime Healthcare Services Landmark LLC	RI	Orthopaedic Surgery Physician	$0	$1.3M
Chandan Lakhiani	RI	Pediatrics Physician	$0	$1.3M
Eilean Attwood	RI	Obstetrics & Gynecology Physician	$0	$1.3M
Ambreen Ijaz	RI	Hematology & Oncology Physician	$29K	$1M
Nebyou Belay	RI	Child & Adolescent Psychiatry Physician	$3.2K	$997.5K
Steven Graff	RI	Orthopaedic Hand Surgery Physician	$67.7K	$798.6K

Nearby Providers

Other providers in the same ZIP code as Stanley Balon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Alliance	RI	Community/Behavioral Health Agency	$0	$46.4M
R.i.s.a.t., LLC	RI	Methadone Clinic	$306K	$21.6M
Thundermist Health Center	RI	Dental Clinic/Center	$0	$18.6M
Thundermist Health Center	RI	Federally Qualified Health Center (FQHC)	$0	$15.8M
Action Based Enterprises	RI	Developmentally Disabled Services Day Training Agency	$0	$15.2M
Woonsocket Education Department	RI	Local Education Agency (LEA)	$0	$9.5M
Woonsocket Housing Authority	RI	Assisted Living Facility	$0	$7M
Beata Nelken	RI	Pediatrics Physician	$0	$4.2M
Tmed Holdings, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$3.8M
Maha Alamad	RI	General Practice Dentistry	$0	$3.5M

Stanley Balon — Billing Profile & Reimbursement Data

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Stanley Balon — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References