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.

Pulmonary And Sleep Office Of New England, PC (NPI 1225159932)

Field	Value
Entity Type	Organization
Organization	Pulmonary And Sleep Office Of New England, PC
Address	3353 Mendon Rd Ste 3
City	Cumberland
State	RI
ZIP	02864
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	April 2, 2007

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	8,750	$60	$533.9K
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…	7,770	$50	$419.5K
G0399	Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation	1,440	$180	$264.3K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	5,300	$20	$127.1K
94726	The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may…	4,570	$30	$123.4K
E0601	Continuous positive airway pressure (CPAP) device	3,240	$40	$123K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	4,670	$30	$121.4K
99205	The provider sees a new 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 provider…	550	$120	$63.1K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	770	$50	$37.1K
99204	The provider sees a new 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 provider…	150	$120	$18.2K

Showing 1–10 of 24

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

Pulmonary And Sleep Office Of New England, PC — 7 of 24 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0399	Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation	2	10	1,440	$230	$454K
E0601	Continuous positive airway pressure (CPAP) device	5	10	2,900	$50	$214.2K
A7030	Full face mask used with positive airway pressure device, each	9	10	640	$80	$137.4K
A7031	Face mask interface, replacement for full face mask, each	9	10	630	$50	$105.1K
A4604	Tubing with integrated heating element for use with positive airway pressure device	7	10	720	$40	$94K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	3	10	280	$140	$90.9K
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…	41	1,730	220	$70	$75.2K
A7034	Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap	7	10	470	$50	$64.2K
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…	2	160	90	$110	$54.6K
A7032	Cushion for use on nasal mask interface, replacement only, each	7	10	300	$40	$51.1K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pulmonary And Sleep Office Of New England, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mohammad Khamiees	RI	Pulmonary Disease Physician	$219.4K	$346.5K

Nearby Providers

Other providers in the same ZIP code as Pulmonary And Sleep Office Of New England, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ocean State Nursing Services, Inc	RI	Home Health Agency	$0	$21.7M
Michael Klufas	RI	Geriatric Medicine (Internal Medicine) Physician	$68.4K	$6.1M
Autumn Villa Inc.	RI	Assisted Living Facility	$0	$5.5M
Open Mri Of New England, Inc.	RI	Diagnostic Radiology Physician	$0	$2.1M
William Chan	RI	Pediatric Dentistry	$0	$1.4M
Cumberland Public Schools	RI	Local Education Agency (LEA)	$0	$1.4M
Lincare Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$1.4M
Denise Goodman	RI	Pediatric Dentistry	$0	$1.3M
Prima Inc	RI	Pediatrics Physician	$0	$1M
Maria Younes	RI	Neurology with Special Qualifications in Child Neurology Physician	$4.7K	$843.6K

Pulmonary And Sleep Office Of New England, PC — Billing Profile & Reimbursement Data

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Pulmonary And Sleep Office Of New England, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References