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.

Diabetes & Endocrinology Associates, Inc. (NPI 1407954415)

Diabetes & Endocrinology Associates, Inc. is a endocrinology, diabetes & metabolism physician provider located in Providence, Rhode Island. This profile covers 0 Medicare and 26 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	Diabetes & Endocrinology Associates, Inc.
Address	100 Highland Ave
City	Providence
State	RI
ZIP	02906
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$730.1K
Medicare	$0

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

26 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…	6,780	$50	$325.5K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	2,540	$30	$78.8K
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…	1,910	$40	$72.4K
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…	510	$120	$60.3K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	6,790	$10	$40.7K
84439	The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum.	5,730	$10	$40.1K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	2,760	$10	$22.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	2,430	$10	$21.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	3,480	$10	$20.9K
83721	The lab analyst performs a test to directly measure the low density lipoprotein, LDL, cholesterol in a patient specimen.	2,680	$10	$13.4K

Showing 1–10 of 26

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

Diabetes & Endocrinology Associates, Inc. — 2 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	9	50	50	$50	$168.1K
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…	29	100	70	$40	$129K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	12	140	140	$30	$99.7K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	24	100	120	$40	$93K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	11	90	120	$30	$83.2K
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…	47	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…	312	2,050	300	$50	$72.3K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	16	160	90	$20	$60.3K
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…	41	300	50	$130	$40.6K
84439	The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum.	4	50	240	$20	$38.6K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Man Chin Chang	RI	Endocrinology, Diabetes & Metabolism Physician	$154.5K	$244.2K
Robert Dobrzynski	RI	Endocrinology, Diabetes & Metabolism Physician	$200.3K	$20.9K
Roberto Ortiz	RI	Endocrinology, Diabetes & Metabolism Physician	$176.3K	$20K
Ameya Hodarkar	MA	Endocrinology, Diabetes & Metabolism Physician	$119.6K	$25.6K
Valerie Thomas	RI	Endocrinology, Diabetes & Metabolism Physician	$131.6K	$40
Alice Haynes	MA	Nurse Practitioner	$56.5K	$2.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Miriam Hospital	RI	General Acute Care Hospital	$0	$138.6M
Family Service Of Rhode Island Inc.	RI	Taxi	$0	$12M
Butler Hospital	RI	Psychiatric Hospital	$0	$9.6M
Phoenix Houses Of New England, Inc.	RI	Substance Abuse Rehabilitation Facility	$0	$7.3M
Thomas Mulvey	RI	Pediatric Dentistry	$0	$6.3M
Silver Fern Practice, LLC	RI	Physical Therapist	$0	$5M
Providence Interventional Associates Ii LLC	RI	Ambulatory Surgical Clinic/Center	$1.9M	$8.3K
Gaurav Gupta	RI	Ophthalmology Physician	$1.8M	$5.8K
Robert Eden	RI	Pediatrics Physician	$0	$1.7M
Brian Ackerman	RI	Psychiatry Physician	$24.8K	$1.5M

Diabetes & Endocrinology Associates, Inc. — Billing Profile & Reimbursement Data

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Diabetes & Endocrinology Associates, 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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