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.

Looking Upwards, Inc. (NPI 1053504548)

Field	Value
Entity Type	Organization
Organization	Looking Upwards, Inc.
Address	1184 E Main Rd
City	Portsmouth
State	RI
ZIP	02871
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	August 20, 2007

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1027	Family training and counseling for child development, per 15 minutes	23,970	$140	$3.3M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	11,500	$150	$1.7M
H2000	Comprehensive multidisciplinary evaluation	1,650	$770	$1.3M
T1016	Case management, each 15 minutes	17,260	$40	$690.4K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	3,220	$110	$340.9K
H0046	Mental health services, not otherwise specified	1,230	$60	$77.3K
T1013	Sign language or oral interpretive services, per 15 minutes	240	$100	$22.8K
H2016	Comprehensive community support services, per diem	5,370	$1	$21.5K

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

Looking Upwards, Inc. — 1 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	17	90	510	$160	$975K
H0046	Mental health services, not otherwise specified	42	70	2,310	$70	$698K
H2000	Comprehensive multidisciplinary evaluation	3	20	540	$690	$525.2K
T1027	Family training and counseling for child development, per 15 minutes	3	90	350	$100	$363.8K
T1016	Case management, each 15 minutes	27	180	400	$20	$230.7K
H2016	Comprehensive community support services, per diem	25	40	10,150	$10	$230.4K
T1013	Sign language or oral interpretive services, per 15 minutes	9	20	900	$70	$206.7K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	3	40	110	$140	$109.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Looking Upwards, Inc.	RI	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$15.7M

Nearby Providers

Other providers in the same ZIP code as Looking Upwards, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Looking Upwards, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$136.2M
Girls And Boys Town Of New England	RI	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$5.9M
Newport County Regional Special Education	RI	Local Education Agency (LEA)	$0	$1.5M
Tom Swanson	RI	Pediatric Dentistry	$0	$1.3M
Gina Digati	RI	Adult Psychiatric/Mental Health Clinical Nurse Specialist	$12.3K	$817.1K
Lighthouse Counseling Associates	RI	Clinical Social Worker	$0	$343.5K
Town Of Portsmouth	RI	Land Ambulance	$265.6K	$75.3K
East Bay Endoscopy Center LLC	RI	Endoscopy Clinic/Center	$330.2K	$0
Julie Deleo	RI	Internal Medicine Physician	$156.9K	$4.4K
Rhode Island Cvs Pharmacy, L.L.C.	RI	Pharmacy	$145.1K	$0

Looking Upwards, Inc. — Billing Profile & Reimbursement Data

Sign up for Looking Upwards, Inc. — Billing Profile & Reimbursement Data policy alerts

Looking Upwards, Inc. — Billing Profile & Reimbursement Data

Sign up for Looking Upwards, Inc. — 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