Loading...
NPI 1215085816 · Riverside, RI · Family Medicine Physician
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Thomas Guttmacher is a family medicine physician provider located in Riverside, Rhode Island. This profile covers 3 Medicare and 12 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Thomas Guttmacher |
| Address | 100 Bullocks Point Ave |
| City | Riverside |
| State | RI |
| ZIP | 02915 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | January 8, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $133.4K |
| Medicare | $390 |
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 80305 | The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes… | 20 | $10 | $220 |
| 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).… | 10 | $10 | $130 |
| 82962 | Blood glucose monitoring at home with small electronic devices is an easy method to check blood sugar level on a daily basis. The patient himself can perform the procedure and the result is obtained… | 10 | $1 | $40 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,210 | $40 | $47K |
| 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… | 800 | $60 | $44.6K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 160 | $170 | $27.3K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 330 | $30 | $8.5K |
| 80305 | The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes… | 230 | $10 | $1.6K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 10 | $100 | $1.2K |
| T1017 | Targeted case management, each 15 minutes | 30 | $30 | $950 |
| 99396 | The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64. | 10 | $70 | $880 |
| T1015 | Clinic visit/encounter, all-inclusive | 60 | $20 | $870 |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 30 | $10 | $210 |
Showing 1–10 of 12
How this provider's Medicaid billing volume and revenue compare to other Rhode Island providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Rhode Island median
12 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 86 | 120 | 400 | $130 | $896.9K |
| T1017 | Targeted case management, each 15 minutes | 17 | 20 | 170 | $80 | $259.8K |
| 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… | 421 | 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… | 461 | 2,050 | 300 | $50 | $72.3K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 149 | 160 | 90 | $110 | $54.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 180 | 240 | 70 | $10 | $37.7K |
| 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).… | 193 | 210 | 100 | $20 | $31.6K |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which… | 18 | 60 | 70 | $70 | $26.5K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 128 | 500 | 90 | $50 | $24.9K |
| 99396 | The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64. | 107 | 120 | 50 | $70 | $9.9K |
Showing 1–10 of 12
Other providers in the same ZIP code as Thomas Guttmacher, ranked by combined Medicare and Medicaid revenue.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.