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.

Lahey Clinic, Inc. (NPI 1538194980)

Lahey Clinic, Inc. is a internal medicine physician provider located in Burlington, Massachusetts. This profile covers 0 Medicare and 113 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	Lahey Clinic, Inc.
Address	41 Mall Rd
City	Burlington
State	MA
ZIP	01805
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

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

113 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…	37,730	$40	$1.5M
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.	16,120	$70	$1.1M
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…	5,770	$70	$404.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	9,870	$30	$306.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	9,530	$30	$276.2K
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…	10,400	$30	$260.1K
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…	4,410	$50	$198.4K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	64,410	$1	$193.2K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	8,360	$20	$125.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4,950	$20	$109K

Showing 1–10 of 113

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

Lahey Clinic, Inc. — 3 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

113 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	69	520	120	$130	$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.	413	550	110	$120	$865.5K
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.	142	830	130	$120	$671K
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…	217	1,620	580	$80	$599.6K
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.	77	220	280	$100	$491.2K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	20	50	630	$460	$459.9K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	48	230	330	$70	$343.3K
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…	77	110	310	$210	$331K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	526	1,020	460	$100	$293.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	52	230	380	$90	$256.4K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lahey Clinic Hospital, Inc.	MA	General Acute Care Hospital	$0	$112.9M
Adam Lipman	VA	Ophthalmology Physician	$3.7M	$0
Kendra Klein-mascia	MA	Ophthalmology Physician	$1.4M	$0
David Ramsey	MA	Ophthalmology Physician	$1M	$0
Jeffrey Marx	MA	Ophthalmology Physician	$933.2K	$0
Stephen Lyle	MA	Anatomic Pathology Physician	$852.2K	$40.3K
Kirubakaran Siva	MA	Family Medicine Physician	$773.7K	$1.7K
Chieke Udom	MA	Hospitalist Physician	$629.2K	$0
Lahey Clinic Hospital Inc	MA	Ambulance	$433.4K	$72.9K
Syed Akbar	IL	Diagnostic Radiology Physician	$280.8K	$223.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Naveen Rao	MA	Cornea and External Diseases Specialist Physician	$392.8K	$0
Pauline Reohr	MA	Dermatology Physician	$385.6K	$0
Sherry Emery	MA	Anatomic Pathology & Clinical Pathology Physician	$208.6K	$64.9K
Christopher Wright	MA	Radiation Oncology Physician	$267.5K	$0
Anne Morris	MA	Diagnostic Radiology Physician	$254.1K	$0
Robert Whitmore	MA	Neurological Surgery Physician	$240.6K	$0
Andrew Kowal	MA	Pain Medicine (Anesthesiology) Physician	$226.3K	$1.7K
Jeanette Chun	MA	Diagnostic Radiology Physician	$177.3K	$48.9K
Mustafa Albakour	MA	Internal Medicine Physician	$145.2K	$47.9K
Jonathan Silver	MA	Clinical Cardiac Electrophysiology Physician	$189.6K	$1.1K

Lahey Clinic, Inc. — Billing Profile & Reimbursement Data

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Lahey Clinic, 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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