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

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

Carmen Rinaldi (NPI 1083694509)

Field	Value
Entity Type	Individual
Organization	Carmen Rinaldi
Address	50 Sewall St
City	Portland
State	ME
ZIP	04102
Taxonomy	Dermatology Physician
NPI Enumerated	January 19, 2006

Payer Source	Total Paid
Medicare	$367.9K
Medicaid	$0

Key Findings

Medicare revenue is narrowly concentrated: the precomputed top three Medicare codes — 88305, 99213, and 17000 — account for 85.6% of this provider's total Medicare revenue. In particular, 88305 alone generates $283.7K (76.7% of Medicare revenue) from 5.6K claims, making it the dominant revenue driver against a total Medicare revenue of $367.9K.

The code mix indicates a pathology-heavy dermatology practice that also performs office-based lesion treatments and evaluation visits. Code 88305 (surgical pathology, level IV) is the primary revenue source, while 99213 ($22.1K; 6.0% of Medicare revenue; 356 claims) and 17000 ($10.9K; 2.9% of Medicare revenue; 279 claims) show routine outpatient evaluation and premalignant lesion destruction as complementary services.

This provider is effectively single-payer from a public-program perspective: Medicare revenue is $367.9K and Medicaid shows none (no Medicaid billing on file). The absence of Medicaid billing suggests limited or no participation in Medicaid-managed care or a payer mix concentrated on Medicare fee-for-service.

Competitive standing varies by code: for the dominant pathology code 88305 the provider ranks #554 of 14580 providers nationally (96th percentile) and is labeled in the file as typical, unremarkable volume for this code, indicating comparatively high national activity on that specific pathology service. By contrast, 17000 ranks #7480 of 21879 (66th percentile) and is described as typical volume, reflecting a more modest national standing for lesion-destruction procedures, while 99213 ranks #46665 of 457151 (90th percentile) indicating solid but not exceptional office-visit volume relative to peers.

The service-detail and add-on codes reinforce high specimen and lab activity: multiple pathology and immunostain codes appear on the file (for example, 88312: 60 claims, $82 avg paid/claim, $4.9K revenue; 88342: 142 claims, $26 avg paid/claim, $3.7K revenue; 88304: 108 claims, $29 avg paid/claim, $3.1K revenue). These lab-related revenues, combined with 88305 dominance, point to substantial specimen processing and diagnostic interpretation as core operational work.

Operational throughput appears oriented toward high-volume specimen handling rather than high-value office E/M billing. E/M codes like 99213 and 99214 together contribute a small share of total Medicare revenue ($22.1K and $3.4K respectively) compared with 88305, which suggests that clinic visits support biopsy and pathology workflows rather than serving as the primary revenue base.

Some procedure-level patterns show frequent small-unit billing: for example, add-on code 17003 reports 882 claims with a $5 avg paid/claim yielding $4.4K (1.2% of Medicare revenue), indicating many encounters with multiple treated lesions recorded as low-paid add-on units. That combination of many small-unit procedures plus dominant pathology revenue is consistent with a practice doing numerous biopsies or lesion treatments per patient encounter.

Tenure in the Medicare program is long-standing: the NPI was enumerated on 2006-01-19 (~20 years ago), which supports an established billing history and operational presence in the Portland, ME market over multiple Medicare payment cycles.

Medicare: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,560	$50	$283.7K
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…	360	$60	$22.1K
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	280	$40	$10.9K
17110	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…	90	$80	$6.8K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	90	$70	$5.9K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	60	$80	$4.9K
17003	In this add–on procedure, the provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code is appropriate for the second through…	880	$10	$4.4K
17262	The provider destroys a malignant lesion on the trunk, arms, or legs using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. The malignant lesion is 1.1 cm to 2.0 cm in…	40	$110	$4.3K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	140	$30	$3.7K
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…	40	$100	$3.4K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Maine Distribution

Carmen Rinaldi — 2 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	1	60	480	$30	$28.8K
11102	38	70	90	$60	$9.3K
17000	22	90	140	$40	$7.5K
99214	1,855	2,500	70	$70	$7.2K
17110	32	70	70	$70	$6.6K
88341	44	50	220	$20	$5.8K
17262	12	30	30	$110	$5K
99213	64	2,350	50	$50	$4.3K
88342	14	50	100	$30	$3.4K
11103	39	50	50	$40	$3.2K

Showing 1–10 of 21

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Macneal	FL	MOHS-Micrographic Surgery Physician	$716.7K	$0
Richard Torbeck	NY	MOHS-Micrographic Surgery Physician	$415.3K	$0
Dermatology Associates, LLC	ME	Dermatology Physician	$0	$409.2K
Kerry Lavigne	ME	MOHS-Micrographic Surgery Physician	$268K	$0
Michael Frank	PA	MOHS-Micrographic Surgery Physician	$209.1K	$0
Christopher Steen	ME	Dermatology Physician	$192.3K	$0
Soren Craig-muller	ME	Dermatology Physician	$189.1K	$0
Rachel Gormley	ME	Dermatopathology Physician	$187.2K	$0
Allen Bruce	ME	Dermatology Physician	$176.4K	$0
Nathan Brewer	ME	Dermatology Physician	$175.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Shalom House, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$81.9M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M

Carmen Rinaldi — 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