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.

Newport Hospital (NPI 1457346413)

Field	Value
Entity Type	Organization
Organization	Newport Hospital
Address	11 Friendship St
City	Newport
State	RI
ZIP	02840
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 15, 2005

Payer Source	Total Paid
Medicaid	$15.8M
Medicare	$0

Key Findings

NEWPORT HOSPITAL has no Medicare billing on file and reports $15.8M in lifetime Medicaid revenue, making Medicaid the dominant payer in its available claims data and effectively the primary public payer exposure for this facility. Analysts should treat the provider as a Medicaid-centric hospital for payer-mix and contracting modeling because Medicare activity is absent from the record.

Revenue concentration is notable: the precomputed top 3 Medicaid codes by revenue account for 33.7% of this provider's total Medicaid revenue. Those top three codes are 99285 ($1.5M, 13.5%), 97110 ($1.1M, 10.4%), and 99284 ($1.1M, 9.8%), indicating a small set of services drives a third of Medicaid receipts.

The code mix indicates an emergency-department–driven acute care operation: high-revenue ED E/M codes include 99285 (3.1K claims, $469 avg paid/claim, $1.5M), 99284 (4.5K claims, $234 avg paid/claim, $1.1M), 99283 (5.1K claims, $179 avg paid/claim, $915.6K), and 99282 (1.7K claims, $195 avg paid/claim, $330.1K). These volumes and dollar values, together with frequent use of imaging, labs, and IV/infusion codes, point to a high-throughput ED that also generates significant ancillary revenue.

Physical and rehabilitative services are a clearly material line: 97110 has 10.6K claims and $1.1M in revenue (10.4% of total Medicaid revenue) and ranks #18 of 360 in-state (95th percentile). The presence of 97140 (3.7K claims, $311.7K, 2.9%) further confirms an embedded outpatient or inpatient rehab/therapy capability that contributes meaningfully to Medicaid revenue.

Ancillary diagnostics and imaging contribute substantial Medicaid dollars and support the ED/acute case mix: lab panels and tests such as 80053 ($704.1K), 85025 ($645.8K), 80048 ($402.8K), and 82248 ($265.4K) appear among top lines, while imaging/imaging supply codes like 74177 ($439.7K), 77067 ($419.3K), and contrast Q9967 ($350.3K) further monetize diagnostic throughput. These items indicate reliance on in-house lab and imaging capacity to capture downstream revenue from ED and procedural encounters.

On competitive standing within the state Medicaid market, the provider ranks at or above the 95th percentile for several core ED codes—99285 is #15 of 277 (95th), 99284 is #14 of 339 (96th), and 99283 is #10 of 291 (97th)—which positions NEWPORT HOSPITAL as a leading Medicaid ED performer in Rhode Island. In contrast, some ancillary medications and infusion items sit in mid-range percentiles (for example, J2405 ranks in the 43rd percentile and J7030 in the 64th), indicating the hospital is especially strong on E/M and therapy volumes but more typical on certain supply/infusion categories.

Infusion and procedural medication activity is present but not dominant: 96374 ($251.1K), 96375 ($221K), J7030 ($207K), and J2405 ($180.9K) together reflect routine IV/infusion services and medication administration tied to acute care episodes. Their rank percentiles (ranging from the mid-40s to mid-60s for some items) suggest these services support ED and inpatient care but are not outlier revenue drivers compared with other Medicaid providers.

The provider’s NPI was enumerated on 2005-09-15 (~21 years ago), indicating an established operational tenure in the market. Taken together with the Medicaid-focused revenue profile and the concentration in ED, imaging, labs, and therapy codes, this history suggests a stable regional acute-care hospital whose strategic and contracting discussions should emphasize Medicaid reimbursement, ED throughput, and ancillary service capacity.

Medicaid: Complete Services Breakdown

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

147 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,120	$470	$1.5M
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…	10,640	$110	$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.	4,520	$230	$1.1M
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.	5,120	$180	$915.6K
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.	5,030	$140	$704.1K
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…	8,610	$80	$645.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	760	$580	$439.7K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	2,450	$170	$419.3K
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…	3,530	$110	$402.8K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	1,610	$220	$350.3K

Showing 1–10 of 147

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

Newport Hospital — 4 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

147 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	10	30	260	$60	$3.4M
G0378	Hospital observation service, per hour	8	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.	19	50	330	$50	$2.7M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	7	10	220	$740	$2.6M
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…	8	20	840	$210	$789.2K
J7040	Infusion, normal saline solution, sterile (500 ml = 1 unit)	8	10	120	$290	$535.1K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	12	20	190	$520	$504.7K
J2405	Injection, ondansetron hydrochloride, per 1 mg	9	20	1,080	$180	$470.2K
J7030	Infusion, normal saline solution , 1000 cc	5	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.	5	10	270	$210	$419.8K

Showing 1–10 of 147

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Newport Hospital	RI	Psychiatric Hospital Unit	$0	$3.1M
Xiaoping Zhou	VA	Anatomic Pathology & Clinical Pathology Physician	$968.4K	$59.3K
Kristin Lombardi	RI	Pediatric Cardiology Physician	$0	$333.6K
Keith-austin Scarfo	RI	Anesthesiology Physician	$56.4K	$273.9K
Laert Rusha	RI	Pain Medicine Physician	$33.7K	$285.7K
Claudia Wheeler	RI	Physical Medicine & Rehabilitation Physician	$244.6K	$0
Leslie Robinson-bostom	RI	Dermatology Physician	$140.3K	$79.8K
Brian Mcmillen	RI	Anatomic Pathology & Clinical Pathology Physician	$177.3K	$25K
Gladys Telang	RI	Dermatology Physician	$76.6K	$103.2K
Mirela Stancu	VA	Anatomic Pathology & Clinical Pathology Physician	$51.6K	$104.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
James L Maher Center	RI	Multi-Specialty Clinic/Center	$0	$52.5M
East Bay Communtiy Action Program	RI	Case Management Agency	$0	$4.9M
Faith Drennon	RI	Pediatric Dentistry	$0	$2.8M
East Bay Community Action Program	RI	Dental Clinic/Center	$0	$2M
Jasma Patel	RI	Dentist	$0	$1.9M
Newport Public Schools	RI	Local Education Agency (LEA)	$0	$1.6M
Charles Stengel	RI	Emergency Medicine Physician	$59K	$870.4K
City Of Newport	RI	Land Ambulance	$306K	$580.6K
St. Clare Home, Inc.	RI	Skilled Nursing Facility	$0	$464.8K
Deborah Saboya	RI	Clinical Social Worker	$0	$357.9K

Newport Hospital — Billing Profile & Reimbursement Data

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Newport 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