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 Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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.

Medical Associates Of Ebnhc (NPI 1255451597)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medical Associates Of Ebnhc
Address	10 Gove St
City	East Boston
State	MA
ZIP	02128
Taxonomy	Community Health Clinic/Center
NPI Enumerated	March 30, 2007

Payer Source	Total Paid
Medicaid	$179.5M
Medicare	$0

MEDICAL ASSOCIATES OF EBNHC reports no Medicare billing on file and $179.5M in lifetime Medicaid revenue, making it effectively a single‑payer (Medicaid) operation at the claims level. The absence of Medicare activity combined with large Medicaid receipts indicates the organization is focused on serving Medicaid populations rather than Medicare beneficiaries. This payer concentration will shape contracting, risk, and revenue discussions for analysts evaluating the entity.

Revenue is highly concentrated in a small set of outpatient evaluation-and-management codes: the precomputed top three Medicaid codes account for 58.0% of Medicaid revenue, driven by 99213 ($53.2M; 35.5%), 99214 ($23.5M; 15.7%), and 99283 ($10.1M; 6.7%). That concentration signals heavy reliance on ambulatory established-patient visits and a substantial share of emergency-department E/M revenue for financial stability. Analysts should treat these codes as the primary revenue levers and areas of operational risk.

The code mix strongly indicates a comprehensive community health center model: high volumes and revenue for 99213, 99214, 99212 and a string of preventive E/M codes (99391, 99392, 99393, 99394, 99395, 99396) plus immunizations (90471, 90651) and contraceptive services (J7307). These lines point to broad primary care, pediatrics, preventive services, immunization programs, and family planning being core service lines rather than narrow specialty care. This operational footprint aligns with the provider taxonomy of Community Health Clinic/Center.

MEDICAL ASSOCIATES OF EBNHC appears to operate substantial emergency or urgent care capacity within its Medicaid business: ED E/M codes 99283 ($10.1M; 6.7%), 99284 ($6.4M; 4.3%), 99282 ($3.9M; 2.6%) and higher‑level 99285 ($3.9M; 2.6%) are all material revenue contributors, and 96361 (IV fluids) adds $3.9M (2.6%). The high ranks on several ED codes (for example, 99283 ranks #12 of 547; 98th percentile, labeled an extreme outlier) support the interpretation that this site treats large volumes of acute presentations compared with in‑state peers.

On competitive standing within Massachusetts, this provider is a dominant statewide player for many ambulatory and preventive codes: 99213 ranks #1 of 5303 providers (100th percentile; extreme outlier), 99391 ranks #1 of 550 (100th percentile; extreme outlier), and several other well and preventive codes sit at #1 or #2 and 100th percentile positions. Those rank/percentile positions indicate the organization is far above typical state volumes for core primary care and preventive services and should be considered a major provider in Medicaid primary care contracting and access planning.

Specialty ancillary services are also offered at scale: ophthalmology/optometry-related codes (92014, 92004, 92012, 92340) generate multi‑million dollar revenue lines (for example, 92014 $3.3M) and rank among the state’s highest-volume providers. The prominence of these vision codes indicates an integrated model that includes eye care inside the clinic network rather than referring all eye services externally, expanding the center’s service breadth and revenue diversity.

Not every service line is an outlier despite the overall scale: some codes report more typical volumes—96361 (IV fluids) sits at the 55th percentile and is labeled typical/unremarkable, and 99285 is at the 89th percentile (typical/unremarkable). This mix of extreme outlier codes and a few services at or near statewide norms suggests that while the center dominates core ambulatory care, specific procedures and higher‑acuity ED care are closer to peer averages.

The provider’s NPI has been enumerated since 2007-03-30 (~19 years ago), reflecting a long tenure in the community. That longevity, combined with concentrated Medicaid revenue and repeated top‑state rankings across primary care, preventive, pediatric, vision, and some ED services, suggests an established community health center operating at scale and should be factored into network adequacy, utilization, and access analyses by payer and provider analysts.

Medicaid: Complete Services Breakdown

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

368 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…	516,080	$100	$53.2M
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…	232,270	$100	$23.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	83,210	$120	$10.1M
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,…	107,970	$90	$9.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	52,630	$120	$6.4M
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…	43,520	$100	$4.5M
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…	39,780	$100	$4.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	36,000	$110	$3.9M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	8,560	$450	$3.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	20,740	$190	$3.9M

Showing 1–10 of 368

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.

Claims Volume vs. Massachusetts Distribution

Medical Associates Of Ebnhc — 22 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

368 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	40	90	7,560	$350	$4.2M
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.	29	80	4,380	$140	$1.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	59	520	120	$130	$1M
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	35	60	1,750	$260	$907.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	12	550	110	$120	$865.5K
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.	14	410	140	$110	$742.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	29	830	130	$120	$671K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	99	370	500	$40	$605.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	144	1,620	580	$80	$599.6K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	2	20	480	$640	$583.9K

Showing 1–10 of 368

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Suffolk Community Services Inc.	MA	Clinic/Center	$0	$50M
Neighborhealth Corporation	MA	Community Health Clinic/Center	$0	$17M
Rehabilitation & Health, Inc.	MA	Substance Abuse Rehabilitation Facility	$0	$14.8M
North Suffolk Community Services Inc.	MA	Developmental Disabilities Clinic/Center	$0	$11.3M
Quest Diagnostics Massachusetts LLC	MA	Clinical Medical Laboratory	$27K	$216.7K
Adrianna D'aurora	MA	Occupational Therapist	$210.1K	$0
Jeffrey Schapiro	MA	Internal Medicine Physician	$17.5K	$3.5K

Medical Associates Of Ebnhc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References