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.

North Providence Urgent Care (NPI 1528221470)

North Providence Urgent Care is a urgent care clinic/center provider located in North Providence, Rhode Island. This profile covers 0 Medicare and 15 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	North Providence Urgent Care
Address	1830 Mineral Spring Ave
City	North Providence
State	RI
ZIP	02904
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	July 9, 2008

Payer Source	Total Paid
Medicaid	$730.9K
Medicare	$0

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

15 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…	4,300	$60	$270.8K
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…	5,270	$50	$253K
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…	990	$80	$75.1K
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…	660	$100	$66.8K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	960	$30	$29.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	910	$10	$11.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	610	$20	$9.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	800	$10	$8.8K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	820	$1	$1.6K
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…	30	$60	$1.6K

Showing 1–10 of 15

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

North Providence Urgent Care — 2 of 15 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

15 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…	78	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…	94	2,050	300	$50	$72.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	54	100	90	$100	$70.7K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	7	30	90	$30	$53.7K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	43	130	260	$30	$52K
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…	39	300	50	$130	$40.6K
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…	35	350	80	$90	$40.5K
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,…	331	500	90	$50	$24.9K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	69	110	110	$20	$24.4K
70210	The provider performs X–ray examination of paranasal sinuses for the assessment of sinusitis.	6	10	80	$20	$13.9K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Regis Burlas	OH	Anesthesiology Physician	$9.5K	$1.3M
Ambreen Ijaz	RI	Hematology & Oncology Physician	$29K	$1M
Anthony Farina	RI	Internal Medicine Physician	$55.1K	$495.9K
Sheldon Malcolm	RI	Family Medicine Physician	$350	$416.1K
Michael Duque	RI	Internal Medicine Physician	$77.5K	$253.6K
Edward Cullen	RI	Emergency Medical Services (Emergency Medicine) Physician	$14.1K	$263.6K
Dennis Romano	RI	Emergency Medical Services (Emergency Medicine) Physician	$21.1K	$136.5K
M Aurora Balerdi	RI	Internal Medicine Physician	$41.2K	$79.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Providence Center Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$170.9M
Re-focus Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$102.5M
Hopehealth Hospice & Palliative Care	RI	Community Based Hospice Care Agency	$0	$33.3M
Mas Medical Staffing	RI	Home Health Agency	$0	$24.5M
Generations Adult Day Health Center	RI	Adult Day Care Clinic/Center	$0	$16.3M
Prospect Chartercare Sjhsri, LLC	RI	General Acute Care Hospital	$0	$10.9M
Global Homecare And Staffing Inc	RI	Home Health Agency	$0	$8.3M
Emergency Care Services Of New England PC	RI	Emergency Medicine Physician	$0	$6.9M
State Of Rhode Island	RI	Clinical Medical Laboratory	$570	$6.4M
The Providence Center	RI	Community/Behavioral Health Agency	$0	$5.9M

North Providence Urgent Care — Billing Profile & Reimbursement Data

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North Providence Urgent Care — 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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