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.

Caille Roy (NPI 1033629068)

Field	Value
Entity Type	Individual
Organization	Caille Roy
Address	57 River Rd
City	Andover
State	MA
ZIP	01810
Taxonomy	Family Nurse Practitioner
NPI Enumerated	October 4, 2017
NPI Deactivated	December 7, 2017

Payer Source	Total Paid
Medicare	$399.8K
Medicaid	$0

Key Findings

This provider’s billing is effectively single-payer: lifetime Medicare revenue totals $399.8K and there is no Medicaid billing on file. For analysts focused on Medicaid populations or state Medicaid risk, this profile should be treated as not present in Medicaid claims data rather than simply low-volume.

Revenue is highly concentrated in chronic care management and remote monitoring codes: 99439, 99490, and 99457 together account for 57.6% of this provider’s total Medicare revenue. That concentration indicates a business model that depends on monthly care-management and remote monitoring services rather than high volumes of in-person primary care E/M office visits.

Top-code utilization is sizable in absolute and proportional terms: 99439 shows 2.6K claims and $97.9K revenue (24.5% of Medicare revenue), 99490 shows 1.8K claims and $87.8K revenue (22.0%), and 99457 shows 1.1K claims and $44.5K revenue (11.1%). These three codes together drive the majority of Medicare dollars billed by this Family Nurse Practitioner.

The provider ranks strongly on national comparisons for several RPM/CCM and RTM codes, suggesting above-typical volume versus peers: 99439 ranks #40 of 8395 providers (100th percentile, described as typical, unremarkable volume for this code), 99490 ranks #392 of 16216 (98th percentile, typical, unremarkable volume), and 98977 ranks #11 of 429 (98th percentile, typical, unremarkable volume). These placements imply the provider is a prominent national biller for remote-monitoring and chronic-care management services relative to peer providers.

Beyond the top three, the code mix shows breadth across remote physiologic monitoring (99454: 1K claims, $42.8K revenue, 10.7% of Medicare revenue; 99458: 722 claims, $23.1K, 5.8%) and time-based complex care management (99489: 373 claims, $21.3K, 5.3%; 99487: 166 claims, $17.6K, 4.4%). Many of these codes are labeled in the source as "typical, unremarkable volume for this code," indicating that while the provider bills these services routinely, the utilization conforms to expected patterns rather than being flagged as an outlier.

The practice also bills for home/residence E/M high-time visits (99345: 112 claims, $17.1K, 4.3%; 99350: 71 claims, $10.2K, 2.5%), which complements the remote-monitoring emphasis and suggests an operational model that combines virtual monitoring with occasional high-intensity home visits. These home visit revenues are meaningful but represent a minority share of total Medicare revenue compared with CCM/RPM codes.

Provider tenure supports an established Medicare presence: the NPI was enumerated on 2017-10-04 (~9 years ago) under the Family Nurse Practitioner taxonomy. The combination of nearly a decade of enrollment and concentrated Medicare revenue in CCM/RPM suggests a stable, service-line-specific practice rather than transient or newly adopted billing behavior.

Medicare: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	2,580	$40	$97.9K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	1,760	$50	$87.8K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	1,140	$40	$44.5K
99454	The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period.	1,040	$40	$42.8K
99458	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.…	720	$30	$23.1K
99489	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	370	$60	$21.3K
98977	The provider supplies one or more devices for remote therapeutic monitoring (RTM) of the musculoskeletal system for monitoring that occurs for 16 to 30 days in a 30–day period.	500	$40	$21K
99487	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	170	$110	$17.6K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	110	$150	$17.1K
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	70	$140	$10.2K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Caille Roy — 8 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99350	13	190	60	$120	$14.1K
99490	1	230	180	$50	$12.8K
99457	1	90	120	$40	$8.3K
99454	1	70	130	$40	$8.1K
99458	1	60	140	$30	$8K
99439	1	170	120	$40	$6.9K
99487	1	50	40	$90	$5.3K
99345	1	80	30	$140	$5.2K
99489	1	40	40	$50	$3.5K
99344	14	70	20	$100	$3.3K

Showing 1–10 of 13

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$9.3M
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$8.1M
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$4.7M
Colette Tefft	NH	Psychiatric/Mental Health Nurse Practitioner	$920	$211.3K
Mukti Patel-prineas	CT	Family Medicine Physician	$144K	$0
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$125.7K
Tricia Mendoza	NH	Geriatric Psychiatry Physician	$111.5K	$0
Carissa Kelly	MA	Adult Health Nurse Practitioner	$100.8K	$770
Kimberley Omahoney	NH	Family Nurse Practitioner	$89.2K	$12K
Samborn Hoey	NH	Family Nurse Practitioner	$20.9K	$63.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Partners In Child Development, Inc	MA	Early Intervention Provider Agency	$0	$20.7M
Beyond Healthcare Agency LLC	MA	Home Health Agency	$0	$13.2M
Safetynet Solutions	MA	In Home Supportive Care Agency	$0	$7.8M
Cataract And Laser Center Of The North Shore, LLC	MA	Ambulatory Surgical Clinic/Center	$2.1M	$1.2M
Daniel Morocco	MA	Clinical Psychologist	$21.5K	$1.9M
Town Of Andover	MA	Land Ambulance	$463.2K	$859.6K
Merrimack Valley Health Services Inc	MA	Radiology Clinic/Center	$62.4K	$461.2K
Cvs Pharmacy Inc	MA	Pharmacy	$347.2K	$0
First-call Medical Inc	MA	Physiological Laboratory	$152.4K	$121.9K
Anthony Turiano	MA	Family Medicine Physician	$191K	$0

Caille Roy — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References