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.

Richard Tyler (NPI 1578910147)

Richard Tyler is a pediatrics physician provider located in Woonsocket, Rhode Island. This profile covers 0 Medicare and 17 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	Richard Tyler
Address	450 Clinton St
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	Pediatrics Physician
NPI Enumerated	May 24, 2016

Payer Source	Total Paid
Medicaid	$624K
Medicare	$0

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

17 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…	3,970	$80	$297.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,040	$90	$89.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	940	$90	$84.4K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	670	$70	$46.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	360	$100	$33.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,260	$10	$20.4K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	1,380	$10	$19.3K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	330	$50	$17.4K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	1,110	$10	$5.5K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	550	$10	$3.9K

Showing 1–10 of 17

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

Richard Tyler — 0 of 16 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	133	2,050	300	$50	$72.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	27	190	160	$90	$39.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	39	160	160	$80	$39K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22	190	110	$90	$32K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	36	140	90	$90	$29.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	58	170	160	$50	$23.8K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	49	150	140	$20	$12.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	20	130	150	$20	$11K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	27	500	90	$10	$8.5K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	5	20	100	$10	$5.6K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thundermist Health Center	RI	Dental Clinic/Center	$0	$18.6M
Thundermist Health Center	RI	Federally Qualified Health Center (FQHC)	$0	$15.8M
Eric Prosseda	RI	General Practice Dentistry	$0	$5.2M
Maulik Kotdawala	RI	General Practice Dentistry	$0	$4.6M
Danielle Murphy	RI	Dentist	$0	$4.2M
Beata Nelken	RI	Pediatrics Physician	$0	$4.2M
Abhishek Kapoor	RI	Dentist	$0	$2.7M
Meera Sharma	RI	General Practice Dentistry	$0	$1.8M
Joey Napolitano	RI	Public Health Dentistry	$0	$1.7M
Yamila Cos	RI	General Practice Dentistry	$0	$1.7M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Care Alliance	RI	Community/Behavioral Health Agency	$0	$46.4M
Prime Healthcare Services Landmark LLC	RI	General Acute Care Hospital	$0	$26.2M
R.i.s.a.t., LLC	RI	Methadone Clinic	$306K	$21.6M
Action Based Enterprises	RI	Developmentally Disabled Services Day Training Agency	$0	$15.2M
Woonsocket Education Department	RI	Local Education Agency (LEA)	$0	$9.5M
Woonsocket Housing Authority	RI	Assisted Living Facility	$0	$7M
Tmed Holdings, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$3.8M
Maha Alamad	RI	General Practice Dentistry	$0	$3.5M
Home Care Services Of Ri, Inc.	RI	Home Health Agency	$0	$3.2M
Woonsocket Education Department	RI	Local Education Agency (LEA)	$0	$3M

Richard Tyler — Billing Profile & Reimbursement Data

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Richard Tyler — 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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