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.

Codman Square Health Center Inc (NPI 1396808309)

Codman Square Health Center Inc is a community health clinic/center provider located in Dorchester Center, Massachusetts. This profile covers 0 Medicare and 235 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	Codman Square Health Center Inc
Address	637 Washington St
City	Dorchester Center
State	MA
ZIP	02124
Taxonomy	Community Health Clinic/Center
NPI Enumerated	December 19, 2006

Payer Source	Total Paid
Medicaid	$44.6M
Medicare	$0

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

235 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…	201,870	$80	$15.7M
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…	108,980	$80	$9.2M
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.	41,010	$70	$3M
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,…	18,170	$80	$1.5M
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…	13,640	$80	$1.1M
D9450	N/A	39,880	$20	$677.9K
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…	8,670	$70	$641.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11,690	$50	$631.2K
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…	10,080	$60	$614.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,880	$50	$533.6K

Showing 1–10 of 235

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

Codman Square Health Center Inc — 14 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

235 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	164	550	90	$140	$1.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	96	110	5,660	$30	$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…	41	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.	13	410	140	$110	$742.2K
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…	672	1,620	580	$80	$599.6K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	17	20	480	$640	$583.9K
D9450	N/A	24	150	2,450	$30	$506.8K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	25	220	410	$20	$216.4K
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,…	17	950	90	$100	$212.9K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	25	220	360	$20	$211.8K

Showing 1–10 of 235

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Victory Human Services	MA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$86M
Steward Carney Hospital, Inc.	MA	General Acute Care Hospital	$0	$56.7M
Commonwealth Mental Health & Wellness Center	MA	Mental Health Counselor	$0	$19.9M
Adult Day Health, Inc.	MA	Adult Day Care Clinic/Center	$0	$11.5M
All Boston Elder Care LLC	MA	Adult Day Care Clinic/Center	$0	$10.3M
Adult Day Health, Inc.	MA	Adult Day Care Clinic/Center	$0	$8.7M
Jean Charles	MA	Ophthalmology Physician	$177K	$620.7K
Clifford Gluck	MA	Urology Physician	$530K	$0
Ki-hyuk Yoo	MA	Foot & Ankle Surgery Podiatrist	$423.9K	$1.2K
Derya Hazar	MA	Nephrology Physician	$227.9K	$0

Codman Square Health Center Inc — Billing Profile & Reimbursement Data

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Codman Square Health Center Inc — 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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