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.

David Ashley (NPI 1477523488)

David Ashley is a family medicine physician provider located in Providence, Rhode Island. This profile covers 0 Medicare and 11 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	Individual
Organization	David Ashley
Address	345 Blackstone Blvd
City	Providence
State	RI
ZIP	02906
Taxonomy	Family Medicine Physician
NPI Enumerated	January 23, 2006

Payer Source	Total Paid
Medicaid	$952.3K
Medicare	$0

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

11 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…	5,180	$80	$388.8K
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,…	1,820	$120	$214.9K
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…	1,390	$140	$198.1K
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…	510	$120	$60.8K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	380	$80	$31.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	220	$90	$20.3K
99203	The provider sees a new 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 provider…	270	$50	$14.6K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	80	$130	$10.4K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	540	$20	$10.2K
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…	170	$20	$2.5K

Showing 1–10 of 11

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

David Ashley — 3 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	559	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…	95	2,050	300	$50	$72.3K
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…	12	160	90	$110	$54.6K
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…	82	300	50	$130	$40.6K
99205	The provider sees a new 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 provider…	17	50	50	$180	$40.5K
99203	The provider sees a new 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 provider…	94	350	80	$90	$40.5K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	15	60	150	$70	$38.3K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	20	30	110	$70	$31.7K
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,…	25	500	90	$50	$24.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	19	90	50	$60	$13.8K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matthew Sarasin	RI	Emergency Medicine Physician	$21.9K	$1.9M
Margaret Tryforos	RI	Family Medicine Physician	$8.6K	$651.9K
Vincent Varamo	RI	Emergency Medicine Physician	$33.9K	$603.8K
Fadya Elrayess	RI	Family Medicine Physician	$3.6K	$563.9K
Amber Gul	RI	Internal Medicine Physician	$56.5K	$431.8K
Jeffrey Borkan	RI	Family Medicine Physician	$1.8K	$479.4K
Nadine Himelfarb	RI	Emergency Medicine Physician	$65.3K	$185.7K
Nicole Coleman	RI	Emergency Medicine Physician	$210.6K	$29.6K
Chester Hedgepeth	MA	Cardiovascular Disease Physician	$69.9K	$141.6K
Victoria Leytin	RI	Emergency Medicine Physician	$33.6K	$163.1K

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

David Ashley — Billing Profile & Reimbursement Data

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David Ashley — 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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