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.

Salley Pels (NPI 1114100104)

Salley Pels is a pediatric hematology & oncology physician provider located in Providence, Rhode Island. This profile covers 0 Medicare and 15 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Salley Pels
Address	593 Eddy St
City	Providence
State	RI
ZIP	02903
Taxonomy	Pediatric Hematology & Oncology Physician
NPI Enumerated	December 12, 2007

Payer Source	Total Paid
Medicaid	$508.8K
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	90	$4,610	$433.7K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	140	$150	$21.9K
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…	160	$140	$20.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	580	$20	$10.9K
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…	270	$30	$8.2K
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…	50	$90	$4.3K
85045	The lab analyst uses an automated hematology analyzer to determine the reticulocyte count.	280	$10	$2.8K
80076	The lab analyst performs a hepatic function panel test in which he measures the blood levels of total protein, albumin, alkaline phosphatase, bilirubin, both total and direct, and liver enzymes.	110	$20	$1.8K
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…	60	$20	$1.2K
86140	The lab analyst performs the technical lab test to analyze a specimen, typically serum, for the presence of C reactive protein.	80	$10	$1K

Showing 1–10 of 15

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

Salley Pels — 0 of 14 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	10	90	$4,170	$5.5M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	14	20	310	$210	$394.7K
J7050	Infusion, normal saline solution, 250 cc	7	10	80	$190	$373.6K
80076	The lab analyst performs a hepatic function panel test in which he measures the blood levels of total protein, albumin, alkaline phosphatase, bilirubin, both total and direct, and liver enzymes.	25	40	360	$30	$98.4K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	92	100	120	$40	$93K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	63	290	100	$30	$88K
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…	979	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…	1,600	2,050	300	$50	$72.3K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	68	80	120	$20	$55.5K
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…	25	70	160	$30	$54.5K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhode Island Hospital	RI	General Acute Care Hospital	$0	$380.8M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
Rhode Island Hospital	RI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$13.2M
Edward Medeiros	RI	Nephrology Physician	$87.2K	$6.8M
Lifespan Physician Group, Inc.	RI	Urgent Care Clinic/Center	$0	$6.5M
Lifespan Physician Group, Inc.	RI	General Practice Physician	$0	$5.6M
Rhode Island Hospital	RI	Pediatrics Physician	$0	$5.3M
Lifespan Physician Group, Inc.	RI	Psychiatry Physician	$0	$4.4M
Zobeida Diaz	RI	Psychiatry Physician	$0	$4M
Rhode Island Hospital	RI	Multi-Specialty Clinic/Center	$0	$4M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	RI	Home Health Agency	$0	$32.1M
Children's Friend And Service	RI	Voluntary or Charitable Agency	$0	$18.7M
City Of Providence Rhode Island	RI	Local Education Agency (LEA)	$0	$18.6M
Brown Emergency Medicine	RI	Emergency Medicine Physician	$0	$12.3M
The Providence Center	RI	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
Brown Neurology	RI	Neurology Physician	$0	$9.9M
One Stone L.L.C.	RI	Home Health Agency	$0	$8.6M
Recovery Connection Centers Of America, Inc.	RI	Multi-Specialty Clinic/Center	$0	$7.5M
City Of Providence Rhode Island	RI	Land Ambulance	$917.7K	$6.4M
Westminster Eyecare Associates Inc	RI	Optometrist	$0	$4.9M

Salley Pels — Billing Profile & Reimbursement Data

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Salley Pels — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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