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.

Prima Care, PC (NPI 1265422596)

Prima Care, PC is a clinic/center provider located in Fall River, Massachusetts. This profile covers 0 Medicare and 360 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	Prima Care, PC
Address	277 Pleasant St
City	Fall River
State	MA
ZIP	02721
Taxonomy	Clinic/Center
NPI Enumerated	October 27, 2005

Payer Source	Total Paid
Medicaid	$32.2M
Medicare	$0

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

360 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	183,900	$40	$7M
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…	127,950	$30	$4M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	82,780	$30	$2.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	28,590	$70	$1.9M
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…	19,930	$50	$916.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	43,650	$20	$873K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	38,920	$20	$778.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	17,450	$40	$750.4K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	13,420	$50	$603.9K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	16,630	$30	$548.8K

Showing 1–10 of 360

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

Prima Care, PC — 13 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

360 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	99	130	34,780	$60	$7.4M
H2015	Comprehensive community support services, per 15 minutes	115	150	7,770	$140	$4.8M
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	16	30	90	$410	$2.1M
J2357	Injection, omalizumab, 5 mg	8	10	1,540	$850	$1.6M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	279	310	8,710	$40	$1.6M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	197	240	980	$180	$1.2M
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.	82	80	4,380	$140	$1.1M
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…	63	130	1,830	$60	$974.3K
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.	33	410	140	$110	$742.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	14	120	530	$450	$681.5K

Showing 1–10 of 360

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Milligan	TN	Surgery Physician	$674.1K	$0
Rajendra Patel	FL	Vascular Surgery Physician	$665.1K	$0
Raju Singla	MA	Internal Medicine Physician	$632.7K	$0
Mark Fisher	MA	Rheumatology Physician	$599.6K	$0
Zein Farhat	RI	Family Medicine Physician	$0	$454.3K
Linsey Philip	MA	Infectious Disease Physician	$450.9K	$0
Vincent Frazzini	NY	Neuroradiology Physician	$403.9K	$21.5K
Aqeel Siddiqui	MA	Vascular Surgery Physician	$390.4K	$0
Jonathan Kittredge	SC	Vascular Surgery Physician	$382.9K	$0
Aamir Ahmad	MA	Diagnostic Radiology Physician	$342.4K	$33.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Steward St. Annes Hospital Corporation	MA	General Acute Care Hospital	$0	$82.8M
Mass Care Link, Inc.	MA	Foster Care Agency	$0	$43.3M
Bay Coast Behavioral, LLC	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$14.9M
Bay State Physical Therapy Of Randolph Inc	MA	Physical Therapist	$0	$14.7M
People, Incorporated	MA	Early Intervention Provider Agency	$0	$14.6M
Dental Dreams LLC	MA	General Practice Dentistry	$0	$6.6M
Mary Goncalo	MA	Psychiatric/Mental Health Registered Nurse	$81.6K	$538.5K
Bassem Nasser	MA	Cardiovascular Disease Physician	$372.8K	$0
Ravi Chander	MA	Cardiovascular Disease Physician	$307.9K	$0
Charles Kanaly	MA	Neurological Surgery Physician	$287.8K	$0

Prima Care, PC — Billing Profile & Reimbursement Data

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Prima Care, 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

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