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.

Ocean Medical Practice, Inc. (NPI 1043401979)

Field	Value
Entity Type	Organization
Organization	Ocean Medical Practice, Inc.
Address	20 Cumberland Hill Rd
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 6, 2007

Payer Source	Total Paid
Medicaid	$518.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	7,510	$40	$330.3K
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…	2,660	$60	$165K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	210	$90	$18.6K
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	30	$140	$3.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	10	$70	$940
1036F	N/A	460	$0	$0
3074F	No Summary found for this code	1,230	$0	$0
3075F	No Summary found for this code	380	$0	$0
3078F	No Summary found for this code	570	$0	$0
3079F	No Summary found for this code	1,080	$0	$0

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Ocean Medical Practice, Inc. — 1 of 5 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. Rhode Island median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	125	1,730	220	$70	$75.2K
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…	47	2,050	300	$50	$72.3K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	94	120	50	$70	$9.9K
99442	N/A	30	90	40	$20	$2.2K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	4	10	60	$10	$2.1K
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	4	10	40	$1	$1.9K
3075F	No Summary found for this code	3	10	80	$10	$1.2K
3074F	No Summary found for this code	8	50	70	$1	$1K
3078F	No Summary found for this code	17	80	80	$1	$880
3079F	No Summary found for this code	2	30	30	$1	$580

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Ocean Medical Practice, Inc., 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
Prime Healthcare Services Landmark LLC	RI	General Acute Care Hospital	$0	$26.2M
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

Ocean Medical Practice, Inc. — Billing Profile & Reimbursement Data

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Ocean Medical Practice, 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

Nearby Providers

Frequently Asked Questions

References