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.

Aquidneck Pediatrics LLC (NPI 1245681626)

Aquidneck Pediatrics LLC is a pediatrics physician provider located in Middletown, Rhode Island. This profile covers 0 Medicare and 23 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	Organization
Organization	Aquidneck Pediatrics LLC
Address	1272 W Main Rd
City	Middletown
State	RI
ZIP	02842
Taxonomy	Pediatrics Physician
NPI Enumerated	June 27, 2016

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

23 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…	16,740	$70	$1.2M
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…	3,260	$100	$325.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,280	$100	$225.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,050	$100	$197.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,300	$90	$117.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	970	$110	$110.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10,070	$10	$90.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	4,290	$20	$64.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1,450	$10	$14.5K
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,…	330	$40	$12.9K

Showing 1–10 of 23

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

Aquidneck Pediatrics LLC — 6 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	101	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…	23	2,050	300	$50	$72.3K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	9	30	90	$30	$53.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	8	190	160	$90	$39.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17	160	160	$80	$39K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	23	40	160	$60	$33.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5	190	110	$90	$32K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	10	140	90	$90	$29.2K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	29	30	80	$90	$29K
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,…	127	500	90	$50	$24.9K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Newport County Community Mental Health Center, Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$36.9M
Child And Family Services Of Newport County	RI	Clinic/Center	$0	$4.3M
Royal Middletown Nursing Center LLC	RI	Skilled Nursing Facility	$0	$4.2M
Newport County Community Mental Health Center	RI	Community/Behavioral Health Agency	$0	$1.9M
Sarah Mcneill	RI	Occupational Therapist	$0	$1.6M
Visiting Nurse Services Of Newport And Bristol Counties	RI	Nursing Care Agency	$0	$1.1M
Jason Michaels	RI	MOHS-Micrographic Surgery Physician	$982.9K	$59.5K
Kenneth Kehew	RI	Dentist	$0	$709.5K
Town Of Middletown	RI	Land Ambulance	$324K	$162.5K
Robert Semco	RI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$471.3K

Aquidneck Pediatrics LLC — Billing Profile & Reimbursement Data

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Aquidneck Pediatrics LLC — 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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