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.

Ocean State Nursing Services, Inc (NPI 1609994763)

Field	Value
Entity Type	Organization
Organization	Ocean State Nursing Services, Inc
Address	3929 Mendon Rd
City	Cumberland
State	RI
ZIP	02864
Taxonomy	Home Health Agency
NPI Enumerated	March 27, 2007

Payer Source	Total Paid
Medicaid	$21.7M
Medicare	$0

Key Findings

OCEAN STATE NURSING SERVICES, INC reports no Medicare billing on file and $21.7M in lifetime Medicaid revenue, making its operations effectively single-payer (Medicaid)-focused in the available claims data. The provider's NPI was enumerated on 2007-03-27 (~19 years ago), indicating a long-tenured presence in the Rhode Island home health market.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with S5125 alone representing $21.2M (97.8% of Medicaid revenue). This concentration signals that organizational revenue depends overwhelmingly on one service line rather than a diversified mix of Medicaid codes.

The code mix (S5125 – Attendant care services; per 15 minutes; T1001 – Nursing assessment / evaluation; and S5130 – Homemaker service, nos; per 15 minutes) indicates the provider primarily delivers non-skilled personal care and attendant/home support with periodic nursing assessment rather than high-volume skilled medical procedures. High counts of per-15-minute codes (S5125: 107.1K claims at $198 avg paid/claim; S5130: 1.1K claims at $75 avg paid/claim) are consistent with an agency model built around time-based personal care visits.

S5125 shows very large claim volume (107.1K claims) and drives the Medicaid book of business ($21.2M revenue), but state competitive metrics place that volume in the middle-upper range: it ranks #15 of 83 providers (83th percentile) and is described as typical, unremarkable volume for this code. T1001 (3.9K claims, $393.4K revenue) ranks #6 of 42 (88th percentile) and therefore represents a relatively stronger position for nursing assessment services compared with in-state peers, even though it contributes only 1.8% of the provider's Medicaid revenue.

S5130 contributes a small share ($85.1K, 0.4% of Medicaid revenue) and ranks #26 of 34 (24th percentile), indicating below-average in-state presence for homemaker services; this suggests the agency emphasizes attendant care over traditional homemaker service lines. An additional code, S5152, shows 33 claims with $0 paid and $0 revenue (0.0% of Medicaid revenue) and ranks #1 of 1 (0th percentile), reflecting negligible or non-revenue administrative usage rather than a material service line.

Because S5125 accounts for 97.8% of Medicaid revenue, the provider is exposed to reimbursement or policy changes tied to attendant care billing; any rates, authorization, or service-definition changes affecting S5125 could materially affect the provider's revenue profile. The remainder of Medicaid revenue is distributed across small-volume codes (T1001 at 1.8% and S5130 at 0.4%), offering limited diversification of payment risk.

Operationally, the combination of very high-volume, per-15-minute attendant care billing and a long tenure (NPI since 2007-03-27) suggests an established personal-care home health operator entrenched in time-based attendant service delivery, with routine nursing assessments as a supporting function. Given the provider's single-payer concentration and code mix, payer/provider analysts should view market position as specialized and Medicaid-dependent rather than broadly diversified across payers or clinical service types.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5125	Attendant care services; per 15 minutes	107,120	$200	$21.2M
T1001	Nursing assessment / evaluation	3,930	$100	$393.4K
S5130	Homemaker service, nos; per 15 minutes	1,130	$80	$85K
S5152	N/A	30	$0	$0

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

Ocean State Nursing Services, Inc — 0 of 3 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5125	Attendant care services; per 15 minutes	15	80	13,620	$120	$7.8M
S5130	Homemaker service, nos; per 15 minutes	26	30	10,010	$100	$1.9M
T1001	Nursing assessment / evaluation	6	40	460	$100	$164.4K
S5152	N/A	1	10	30	$0	$0

Nearby Providers

Other providers in the same ZIP code as Ocean State Nursing Services, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Maria Younes	RI	Neurology with Special Qualifications in Child Neurology Physician	$4.7K	$843.6K

Ocean State Nursing Services, Inc — Billing Profile & Reimbursement Data

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Ocean State Nursing Services, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References