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.

Dawn Borschel (NPI 1124002365)

Dawn Borschel is a family medicine physician provider located in Pawtucket, Rhode Island. This profile covers 0 Medicare and 29 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	Dawn Borschel
Address	21 Division St
City	Pawtucket
State	RI
ZIP	02860
Taxonomy	Family Medicine Physician
NPI Enumerated	December 1, 2005

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	3,210	$170	$548.4K
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…	2,130	$90	$193.6K
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…	2,890	$60	$181.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	340	$90	$29.4K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	690	$40	$28.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	90	$180	$15.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	270	$60	$15.2K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	230	$60	$14.3K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	190	$40	$7.2K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	170	$40	$6.9K

Showing 1–10 of 29

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

Dawn Borschel — 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	88	130	140	$70	$160.8K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	24	110	70	$70	$157.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	87	130	130	$70	$141.1K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	36	100	70	$40	$129K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	12	240	150	$80	$91.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	8	30	40	$190	$91.5K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	72	80	100	$40	$90.7K
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…	142	290	100	$30	$88K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	78	90	120	$30	$83.2K
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…	159	1,730	220	$70	$75.2K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gateway Healthcare Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$122.7M
Nursing Placement, Inc.	RI	Home Health Agency	$0	$63.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$21.3M
Lifetime Financial Management Inc.	RI	Home Health Agency	$0	$20.9M
Addiction Recovery Institute	RI	Community/Behavioral Health Agency	$180.1K	$15.4M
Blackstone Valley Community Health Care	RI	Federally Qualified Health Center (FQHC)	$0	$14.2M
Blackstone Valley Community Health Care, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$12.4M
United Cerebral Palsy Of Rhode Island, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$9.6M
Dr. Day Care, Inc.	RI	Counselor	$0	$8.7M
Sheila Brijade	RI	Pediatric Dentistry	$0	$7.7M

Dawn Borschel — 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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References