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

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

Saint Vincent Physician Services, Inc. (NPI 1013997329)

Saint Vincent Physician Services, Inc. is a family medicine physician provider located in Worcester, Massachusetts. This profile covers 0 Medicare and 120 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	Saint Vincent Physician Services, Inc.
Address	123 Summer St Ste 279
City	Worcester
State	MA
ZIP	01608
Taxonomy	Family Medicine Physician
NPI Enumerated	January 20, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

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

120 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…	63,860	$50	$3.3M
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…	26,920	$40	$996K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	9,240	$30	$258.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,230	$40	$169.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	38,950	$1	$155.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,080	$60	$126.8K
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…	1,310	$80	$105.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,450	$30	$96.7K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,370	$60	$86.2K
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…	12,210	$10	$85.5K

Showing 1–10 of 120

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Saint Vincent Physician Services, Inc. — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

120 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	31	50	320	$530	$379.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	43	230	380	$90	$256.4K
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,…	156	950	90	$100	$212.9K
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…	44	5,040	200	$70	$209.5K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	98	190	350	$90	$196K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	63	90	170	$260	$193.6K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	46	260	330	$40	$187.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	109	160	390	$70	$186.5K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	49	80	220	$250	$172.5K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	31	40	130	$450	$169.5K

Showing 1–10 of 120

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Vincent Pediatric Subspecialties	IN	Pediatrics Physician	$0	$20.8M
St Vincent Physician Services Hospital And Health Care Center	IN	Family Medicine Physician	$0	$14M
St. Vincent Williamsport Hospital	IN	Critical Access Hospital	$0	$2.7M
St. Vincent Hospital & Health Care Center, Inc.	IN	Psychiatry Physician	$0	$2.5M
Boris Skurkovich	RI	Pediatrics Physician	$0	$1.2M
Robyn Wing	RI	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$914.6K
Chirag Amin	TN	Hematology & Oncology Physician	$820K	$0
Bruce Waller	IN	Cardiovascular Disease Physician	$540.1K	$0
Marwan Mustaklem	IN	Internal Medicine Physician	$480.3K	$0
Enoch Kassa	IN	Ophthalmology Physician	$461.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vhs Acquisition Subsidiary Number 7 Inc	MA	General Acute Care Hospital	$0	$67.7M
Centro Las Americas	MA	Community Health Worker	$0	$43.7M
Worcester Adult Day Care Center	MA	Adult Day Care Clinic/Center	$0	$15.5M
Center For Living And Working, Inc	MA	Home Health Agency	$0	$14.5M
Secon Of New England LLC	MA	Clinical Medical Laboratory	$0	$8.8M
Arca Adult Day Health Center	MA	Adult Day Care Clinic/Center	$0	$7.2M
Laboratory Corporation Of America Holdings	MA	Clinical Medical Laboratory	$56.5K	$3.2M
Imaging Consultants Inc	MA	Radiology Clinic/Center	$423.5K	$658.5K
Tony Samaha	MA	Hematology & Oncology Physician	$813.5K	$0
Seth Kates	MA	Dermatology Physician	$667.9K	$35K

Saint Vincent Physician Services, Inc. — Billing Profile & Reimbursement Data

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Saint Vincent Physician Services, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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