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.

Kent County Memorial Hospital (NPI 1386643294)

Field	Value
Entity Type	Organization
Organization	Kent County Memorial Hospital
Address	455 Toll Gate Rd
City	Warwick
State	RI
ZIP	02886
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 21, 2005

Payer Source	Total Paid
Medicaid	$90.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused facility: there is no Medicare billing on file while total Medicaid revenue is $90.8M, indicating a Medicaid-dominant payer mix rather than a balanced Medicare/Medicaid case mix. Analysts should treat Medicare-level competitive assessments as not applicable for this entity due to the absence of Medicare claims.

Revenue is highly concentrated in a small set of outpatient and ED-related codes: the top three Medicaid codes (99211, 99285, 97110) together account for 41.7% of Medicaid revenue, with 99211 contributing $11.8M (20.5%), 99285 $6.2M (10.8%), and 97110 $6M (10.4%). This concentration signals that a few high-volume service lines — ambulatory/clinic visits, high-acuity emergency care, and therapeutic exercise/physical therapy — drive a large share of payments.

The facility shows a clear emergency department emphasis: 99285 ($6.2M, 10.8% of Medicaid revenue) ranks #7 of 277 in-state at the 98th percentile (notably above typical state volume), and complementary ED codes 99284 ($4.2M, 7.3%) and 99283 ($2.7M, 4.7%) also sit at the 99th and 98th percentiles respectively. High claim counts for these E/M codes (9.8K for 99285, 11.4K for 99284, 10.6K for 99283) support the interpretation that the hospital functions as a major regional ED hub for Medicaid patients.

Outpatient rehabilitation is another primary service line: 97110 (32.9K claims, $6M, 10.4%) ranks #6 of 360 in-state at the 99th percentile (extreme outlier), and related therapy codes such as 97530 and 97140 are likewise in the high percentiles. The volume and rank profile indicate a robust physical/occupational therapy program that materially contributes to Medicaid revenue.

Clinical diagnostic and cardiac imaging volumes are substantial, consistent with a full-service acute hospital: 85025 (35.5K claims, $2.7M, 4.7%) ranks #5 of 289 (99th percentile), 80048 (24.1K claims, $2.1M, 3.6%) ranks #4 of 98 (97th percentile), 93005 (15.1K claims, $1.4M, 2.5%) ranks #3 of 76 (97th percentile), and 93306 ($1.4M, 2.3%) ranks #3 of 72 (97th percentile). These high laboratory and echo volumes suggest on-site capacity for diagnostics that supports both ED and outpatient services.

There is meaningful capacity for infusion and procedural medication administration: 96375 and 96374 appear among top-paid codes (~$1.1M each combined) and J-codes such as J7030 and J2405 show nontrivial revenue, indicating regular IV/infusion throughput for therapeutic and supportive care. While several infusion and drug administration ranks are characterized as typical or unremarkable statewide, their presence alongside high ED and diagnostic volumes points to integrated acute and post-acute workflows.

The provider is a statistical outlier for several screening and monitoring codes tied to chronic disease management: 82962 (6.9K claims, $873.8K, 1.5%) ranks #1 of 54 in-state at the 100th percentile (extreme outlier), and 83036 (12K claims, $899.3K, 1.6%) ranks #6 of 205 (98th percentile). These patterns suggest a high throughput of point-of-care glucose monitoring and A1C testing, consistent with significant outpatient diabetes management within the Medicaid population.

KENT COUNTY MEMORIAL HOSPITAL is an established provider with an NPI enumeration date of 2005-07-21 (~21 years ago). Statewide competitive standing is strong for multiple service lines: the hospital ranks as an extreme outlier or near the top percentile for key codes such as 99211 (rank #1 of 239, 100th percentile; extreme outlier), 97110 (99th percentile; extreme outlier), and several diagnostics and ED codes in the high 90s. Taken together, tenure plus these high-percentile ranks indicate a long-standing, major Medicaid-focused provider in Rhode Island for emergency care, outpatient therapy, diagnostics, and chronic disease monitoring.

Medicaid: Complete Services Breakdown

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

316 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	67,320	$180	$11.8M
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.	9,840	$630	$6.2M
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…	32,860	$180	$6M
G0378	Hospital observation service, per hour	3,690	$1,150	$4.2M
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.	11,410	$370	$4.2M
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.	10,600	$260	$2.7M
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	35,500	$80	$2.7M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	24,140	$90	$2.1M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	16,720	$90	$1.5M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	15,070	$100	$1.4M

Showing 1–10 of 316

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

Kent County Memorial Hospital — 15 of 25 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

316 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	3	10	1,220	$1,410	$2.9M
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.	9	50	330	$50	$2.7M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	11	10	360	$430	$1.1M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	5	20	840	$210	$789.2K
J0131	Injection, acetaminophen, not otherwise specified,10 mg	3	10	1,670	$280	$740.4K
J7040	Infusion, normal saline solution, sterile (500 ml = 1 unit)	7	10	120	$290	$535.1K
J2405	Injection, ondansetron hydrochloride, per 1 mg	3	20	1,080	$180	$470.2K
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	7	10	140	$360	$452K
J7030	Infusion, normal saline solution , 1000 cc	3	10	720	$180	$426.8K
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.	10	10	270	$210	$419.8K

Showing 1–10 of 316

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kent County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kent County Memorial Hospital	RI	Durable Medical Equipment & Medical Supplies	$0	$2.2M
Nebyou Belay	RI	Child & Adolescent Psychiatry Physician	$3.2K	$997.5K
Maria Gonzalez	RI	Psychiatry Physician	$13.2K	$667.5K
John Gelzhiser	RI	Internal Medicine Physician	$89.6K	$559.3K
Vincent Varamo	RI	Emergency Medicine Physician	$33.9K	$603.8K
Emily Colyer	RI	Emergency Medicine Physician	$36K	$528.6K
Christopher Zabbo	RI	Emergency Medicine Physician	$4.5K	$372.2K
Kristin Lombardi	RI	Pediatric Cardiology Physician	$0	$333.6K
Bruce Koplan	MA	Clinical Cardiac Electrophysiology Physician	$218.7K	$76.4K
Jennifer Jarbeau	RI	Cardiovascular Disease Physician	$61K	$212.5K

Nearby Providers

Other providers in the same ZIP code as Kent County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M
J.arthur Trudeau Memorial Home Based Therapy Services	RI	Community/Behavioral Health Agency	$0	$20.3M

Kent County Memorial Hospital — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References