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.

Ocean State Urgent Care Center Of Cumberland, LLC (NPI 1275971400)

Ocean State Urgent Care Center Of Cumberland, LLC is a urgent care clinic/center provider located in Cumberland, Rhode Island. This profile covers 0 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.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Ocean State Urgent Care Center Of Cumberland, LLC
Address	2140 Mendon Rd
City	Cumberland
State	RI
ZIP	02864
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	June 10, 2013

Payer Source	Total Paid
Medicaid	$447.7K
Medicare	$0

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
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…	4,210	$60	$252.8K
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…	2,070	$50	$93K
99203	The provider sees a new 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 provider…	570	$60	$36.7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	510	$30	$13.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	300	$40	$12.5K
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…	290	$40	$10.8K
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…	110	$90	$10.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	680	$10	$8.8K
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.	500	$10	$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.	130	$20	$1.9K

Showing 1–10 of 12

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

Ocean State Urgent Care Center Of Cumberland, LLC — 1 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	125	240	150	$80	$91.9K
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…	83	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…	288	2,050	300	$50	$72.3K
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…	102	300	50	$130	$40.6K
99203	The provider sees a new 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 provider…	54	350	80	$90	$40.5K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	60	90	80	$30	$27.9K
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,…	298	500	90	$50	$24.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	26	150	120	$30	$16.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	14	90	50	$60	$13.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	30	250	90	$10	$5.7K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southcoast Physicians Group, Inc.	MA	Family Medicine Physician	$0	$49.8M
Regis Burlas	OH	Anesthesiology Physician	$9.5K	$1.3M
Lindsey Monti	NH	Physician Assistant	$28.4K	$324.2K
Nathan Rheault	CA	Family Medicine Physician	$97.3K	$30.6K
Alicia Longani	MA	Medical Physician Assistant	$46K	$0
Andre Covacha	RI	Physician Assistant	$11.9K	$840

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
Pulmonary And Sleep Office Of New England, PC	RI	Pulmonary Disease Physician	$0	$1.9M
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

Ocean State Urgent Care Center Of Cumberland, 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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