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.

Vmd Primary Providers Of Rhode Island PC (NPI 1598341067)

Vmd Primary Providers Of Rhode Island PC is a family medicine physician provider located in Cumberland, Rhode Island. This profile covers 0 Medicare and 34 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	Vmd Primary Providers Of Rhode Island PC
Address	106 Nate Whipple Hwy Ste 101
City	Cumberland
State	RI
ZIP	02864
Taxonomy	Family Medicine Physician
NPI Enumerated	March 23, 2021

Payer Source	Total Paid
Medicaid	$780.7K
Medicare	$0

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

34 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…	6,930	$50	$318.9K
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…	3,840	$50	$199.6K
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…	1,530	$70	$111.5K
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…	1,630	$40	$63.7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,150	$20	$26.5K
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.	2,010	$10	$22.1K
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.	1,690	$10	$15.2K
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…	70	$100	$6.9K
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,…	90	$30	$2.8K
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…	100	$20	$1.6K

Showing 1–10 of 34

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

Vmd Primary Providers Of Rhode Island PC — 5 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

34 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…	93	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…	53	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…	95	100	90	$100	$70.7K
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…	83	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…	131	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…	20	350	80	$90	$40.5K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	51	90	80	$30	$27.9K
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,…	253	500	90	$50	$24.9K
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…	11	170	160	$50	$23.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	12	150	120	$30	$16.4K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pamela Bagdasian	RI	Physician Assistant	$32.5K	$617.3K
Kristen Haviland	RI	Family Nurse Practitioner	$7.4K	$410.7K
Ocean State Urgent Care Center Of Smithfield LLC	RI	Urgent Care Clinic/Center	$0	$403.1K
Neal Kelley	RI	Cardiovascular Disease Physician	$173.2K	$32K
Bartel Crisafi	RI	Family Medicine Physician	$101.9K	$63.2K
Darlene Males	RI	Family Nurse Practitioner	$17.3K	$137.7K
Nitin Damle	RI	Internal Medicine Physician	$147.2K	$5.5K
Elena Lvov	RI	Family Nurse Practitioner	$68.1K	$56.3K
Paul Barratt	RI	Internal Medicine Physician	$89.6K	$3.8K
Sumaira Ali	RI	Internal Medicine Physician	$89.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ocean State Nursing Services, Inc	RI	Home Health Agency	$0	$21.7M
Michael Klufas	RI	Geriatric Medicine (Internal Medicine) Physician	$68.4K	$6.1M
Autumn Villa Inc.	RI	Assisted Living Facility	$0	$5.5M
Open Mri Of New England, Inc.	RI	Diagnostic Radiology Physician	$0	$2.1M
Pulmonary And Sleep Office Of New England, PC	RI	Pulmonary Disease Physician	$0	$1.9M
William Chan	RI	Pediatric Dentistry	$0	$1.4M
Cumberland Public Schools	RI	Local Education Agency (LEA)	$0	$1.4M
Lincare Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$1.4M
Denise Goodman	RI	Pediatric Dentistry	$0	$1.3M
Prima Inc	RI	Pediatrics Physician	$0	$1M

Vmd Primary Providers Of Rhode Island PC — Billing Profile & Reimbursement Data

Sign up for Vmd Primary Providers Of Rhode Island PC — Billing Profile & Reimbursement Data policy alerts

Vmd Primary Providers Of Rhode Island PC — Billing Profile & Reimbursement Data

Sign up for Vmd Primary Providers Of Rhode Island PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References