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.

Neighborhealth Corporation (NPI 1316994411)

Neighborhealth Corporation is a community health clinic/center provider located in East Boston, Massachusetts. This profile covers 0 Medicare and 185 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	Neighborhealth Corporation
Address	10 Gove St
City	East Boston
State	MA
ZIP	02128
Taxonomy	Community Health Clinic/Center
NPI Enumerated	May 27, 2006

Payer Source	Total Paid
Medicaid	$17M
Medicare	$0

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

185 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…	87,210	$30	$2.6M
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…	21,270	$80	$1.7M
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…	150,350	$10	$1.7M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	13,720	$100	$1.3M
90832	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…	23,390	$50	$1.1M
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.	9,920	$80	$793.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	6,840	$110	$759.2K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	12,310	$50	$652.4K
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…	11,450	$50	$526.5K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,690	$120	$431.3K

Showing 1–10 of 185

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

Neighborhealth Corporation — 8 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

185 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	69	70	8,210	$510	$8.6M
S5170	Home delivered meals, including preparation; per meal	47	60	50,010	$20	$2.5M
T1015	Clinic visit/encounter, all-inclusive	133	550	90	$140	$1.5M
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.	117	520	120	$130	$1M
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.	100	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.	35	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.	80	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.	204	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…	86	1,620	580	$80	$599.6K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	11	20	480	$640	$583.9K

Showing 1–10 of 185

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston University Medical Center Radiologists, Inc.	MA	Diagnostic Radiology Physician	$0	$12.8M
Peter Lou	MA	Ophthalmology Physician	$371.5K	$0
Margaret Chapman	WA	Neuroradiology Physician	$291.6K	$8.8K
Ajay Singh	PA	Diagnostic Radiology Physician	$290.3K	$6K
Nikolaos Michalacos	MA	Internal Medicine Physician	$251.5K	$0
Michael Fishman	MA	Diagnostic Radiology Physician	$183.3K	$2K
David Berger	MA	Surgery Physician	$177.7K	$0
Matthew Maeder	NH	Diagnostic Radiology Physician	$165.4K	$0
Logan Frank	MO	Diagnostic Radiology Physician	$152.2K	$0
Alessandro Cancelliere	KY	Emergency Medicine Physician	$117.4K	$21.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medical Associates Of Ebnhc	MA	Community Health Clinic/Center	$0	$179.5M
North Suffolk Community Services Inc.	MA	Clinic/Center	$0	$50M
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

Neighborhealth Corporation — 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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