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.

Rhode Island Hospital (NPI 1083848980)

Field	Value
Entity Type	Organization
Organization	Rhode Island Hospital
Address	22 Baker Street
City	Providence
State	RI
ZIP	02905
Taxonomy	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
NPI Enumerated	May 6, 2009

Payer Source	Total Paid
Medicaid	$13.2M
Medicare	$0

Key Findings

RHODE ISLAND HOSPITAL reports $13.2M in lifetime Medicaid revenue and has no Medicare billing on file, making its observable payer footprint effectively single-payer in Medicaid. The absence of Medicare claims on file means analysis of Medicare-facing competitiveness or fee-for-service Medicare revenue exposure is not possible from the available data.

Revenue is highly concentrated in a very small set of Medicaid codes: the platform’s precomputed top-3 share shows the three leading codes account for 67.9% of the provider’s total Medicaid revenue. The two largest contributors are 90999 ($4.6M, 35.0%) and J2501 ($3.7M, 28.4%), indicating that a majority of Medicaid dollars are tied to dialysis procedural coding and a single dialysis drug.

The code mix and descriptions are consistent with an ESRD/dialysis operation: 90999 (dialysis services with unspecified code) sits at $4.6M of revenue and dominates procedure-related billing, while J2501 (paricalcitol injection) at $3.7M reflects high utilization of targeted mineral-bone-disease therapy commonly used in ESRD populations. A high-volume laboratory panel code, 84100 (phosphate test), also appears among top revenue drivers ($596.4K, 4.5%), supporting a pattern of routine biochemical monitoring typical for dialysis patients.

Competitive standing across these Medicaid codes is mixed. For dialysis procedure coding 90999 the provider ranks #7 of 21 in-state (70th percentile; typical, unremarkable volume for this code), indicating a modest but not dominant role statewide, whereas for J2501 the provider ranks #1 of 3 in-state (100th percentile; typical, unremarkable volume for this code), meaning it is the leading biller of paricalcitol among the very small subset of providers that bill this drug.

Lab and monitoring services are a broad and consistent secondary revenue stream: multiple laboratory CPT codes appear in the top billers (examples include 84100 at 4.5%, 83970 at 2.6%, 84520 at 2.6%, 82728 at 2.5%, and 83550 at 2.4% of Medicaid revenue). These entries reflect routine, recurring lab monitoring associated with dialysis care rather than one-off procedures, suggesting steady utilization of diagnostic testing alongside dialysis services.

The provider also bills for anemia management with J0882 (darbepoetin alfa) at $544.7K (4.1% of Medicaid revenue) and ranks #2 of 3 in-state (50th percentile; typical, unremarkable volume for this code), which aligns with comprehensive ESRD care that includes erythropoiesis-stimulating agents. This mix—procedural dialysis codes, specialty injectable agents, and repeated lab testing—paints a picture of an integrated dialysis service line that manages both treatment delivery and ongoing medical monitoring.

Operationally and financially, the heavy reliance on a few Medicaid codes (the top three contribute 67.9% of Medicaid revenue) creates exposure to reimbursement or utilization changes tied to those specific procedural and drug codes; shifts in policy or supply/use of paricalcitol or dialysis procedure payment could materially affect revenue. Given the provider’s $13.2M Medicaid-only billing profile, any state-level Medicaid policy changes for ESRD services or drugs would disproportionately impact this entity compared with more payer-diversified peers.

The NPI enumeration date is 2009-05-06 (~17 years ago), indicating the provider has been active under the current national identifier for an extended period. That tenure, combined with repeated lab and drug billing patterns, suggests established dialysis operations rather than a recent or transient service offering.

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	10,870	$430	$4.6M
J2501	Injection, paricalcitol, 1 mcg	6,960	$540	$3.7M
84100	The lab analyst performs a test to evaluate the level of phosphate, which is phosphorus not contained in biological compounds, in a patient specimen such as serum.	2,070	$290	$596.4K
J0882	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	1,160	$470	$544.7K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	1,160	$300	$349.5K
84520	The lab analyst performs a test to measure the amount of urea nitrogen in patient blood.	1,300	$260	$340.3K
82728	The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute…	1,160	$280	$323.9K
83550	The lab analyst measures the iron binding capacity, typically in a serum sample. This analyte is an important measurement of the capacity of iron to bind to transferrin. That capacity is also known…	1,170	$270	$319.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	1,150	$280	$318K
83735	The lab analyst performs a test to measure the amount of magnesium in a patient specimen.	1,160	$270	$317.6K

Showing 1–10 of 20

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

Rhode Island Hospital — 1 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	7	20	4,970	$270	$1.8M
J2501	Injection, paricalcitol, 1 mcg	1	10	6,170	$300	$1.5M
J7030	Infusion, normal saline solution , 1000 cc	10	10	720	$180	$426.8K
J0882	Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)	2	10	1,160	$240	$413.5K
83735	The lab analyst performs a test to measure the amount of magnesium in a patient specimen.	11	30	790	$60	$216.6K
82248	The lab analyst measures the amount of direct bilirubin in a patient’s blood. Bilirubin is the yellow color pigment found in the bile, a fluid made by the liver. Direct bilirubin is a water soluble…	8	30	210	$50	$159.7K
84100	The lab analyst performs a test to evaluate the level of phosphate, which is phosphorus not contained in biological compounds, in a patient specimen such as serum.	8	30	340	$70	$140.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	26	140	140	$30	$99.7K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	5	20	190	$90	$73.1K
84520	The lab analyst performs a test to measure the amount of urea nitrogen in patient blood.	9	40	320	$40	$65.8K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhode Island Hospital	RI	General Acute Care Hospital	$0	$380.8M
Rhode Island Hospital	RI	Pediatrics Physician	$0	$5.3M
Rhode Island Hospital	RI	Multi-Specialty Clinic/Center	$0	$4M
Rhode Island Hospital	RI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.6M
George Dupont	RI	Pediatric Dentistry	$0	$2.4M
Rhode Island Hospital	RI	Hematology & Oncology Physician	$0	$2.3M
Brian Savoie	RI	Retina Specialist (Ophthalmology) Physician	$1.4M	$55.1K
Chandan Lakhiani	RI	Pediatrics Physician	$0	$1.3M
Boris Skurkovich	RI	Pediatrics Physician	$0	$1.2M
Kristin Macdougall	NY	Rheumatology Physician	$1.1M	$33.8K

Nearby Providers

Other providers in the same ZIP code as Rhode Island Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Women & Infants Hospital Of Rhode Island	RI	General Acute Care Hospital	$0	$132.1M
Elmwood Home Care, Inc.	RI	Home Health Agency	$0	$38.6M
H&t Medicals, Inc	RI	Home Health Agency	$0	$14.8M
R.i.s.a.t., LLC	RI	Methadone Clinic	$321.1K	$14M
Meeting Street Center	RI	Early Intervention Provider Agency	$0	$13.8M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$13.4M
Women And Infants Hospital	RI	General Acute Care Hospital	$0	$12.6M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Renaissance Adhc, LLC	RI	Adult Day Care Clinic/Center	$0	$7.4M
Catherine Allen	RI	Mental Health Counselor	$0	$7.4M

Rhode Island Hospital — Billing Profile & Reimbursement Data

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Rhode Island Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References