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.

Everest Healthcare Rhode Island, Inc. (NPI 1639188345)

Field	Value
Entity Type	Organization
Organization	Everest Healthcare Rhode Island, Inc.
Address	2814 Post Rd
City	Warwick
State	RI
ZIP	02886
Taxonomy	End-Stage Renal Disease (ESRD) Treatment Clinic/Center
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	17,320	$180	$3.2M
A4657	Syringe, with or without needle, each	5,770	$110	$657.2K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	2,940	$110	$334.9K
84520	The lab analyst performs a test to measure the amount of urea nitrogen in patient blood.	2,230	$130	$290.2K
83540	The lab analyst measures the iron level, primarily in serum. Iron is one of the essential elements in the body, and the greatest portion is present combined with hemoglobin within the red blood cells.	1,430	$140	$203.9K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	1,440	$140	$203.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	1,300	$150	$189.2K
87340	The lab analyst performs a test to detect hepatitis B surface antigen, also called HBsAg, using an immunoassay technique, such as EIA.	1,270	$140	$177.5K
84075	The lab analyst measures the alkaline phosphatase, typically in a serum sample. The origin of the enzyme alkaline phosphatase is primarily from the liver, bone, intestine, and lungs.	940	$130	$126.5K
J0887	Injection, epoetin beta, 1 microgram, (for esrd on dialysis)	940	$130	$118K

Showing 1–10 of 23

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

Everest Healthcare Rhode Island, Inc. — 1 of 23 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	2	20	4,970	$270	$1.8M
A4657	Syringe, with or without needle, each	2	10	460	$130	$238.2K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	29	290	100	$30	$88K
83970	Parathyroid hormone test measures the level of PTH in the blood. This test is done to ascertain the level of calcium and evaluate the parathyroid function.	4	20	190	$90	$73.1K
J1756	Injection, iron sucrose, 1 mg	2	10	510	$80	$66.6K
84520	The lab analyst performs a test to measure the amount of urea nitrogen in patient blood.	7	40	320	$40	$65.8K
82310	The lab analyst measures the calcium level, primarily on a serum sample.	15	20	180	$40	$63.9K
82728	The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute…	18	70	160	$30	$54.5K
80069	The lab analyst performs a renal function panel test in which he measures the blood level of certain chemicals the descriptor lists to evaluate how well the kidney is functioning.	6	10	560	$70	$53.3K
83550	The lab analyst measures the iron binding capacity, typically in a serum sample. This analyte is an important measurement of the capacity of iron to bind to transferrin. That capacity is also known…	12	40	260	$30	$51.9K

Showing 1–10 of 23

Nearby Providers

Other providers in the same ZIP code as Everest Healthcare Rhode Island, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Bay Residential Services Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$145.8M
Kent County Memorial Hospital	RI	General Acute Care Hospital	$0	$90.8M
Avatar Residential, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$72.9M
Thrive Behavioral Health, Inc.	RI	Community/Behavioral Health Agency	$0	$71.9M
Bayada Home Health Care, Inc.	RI	Home Health Agency	$0	$69.5M
Community Living Of Rhode Island	RI	Developmentally Disabled Services Day Training Agency	$0	$65.7M
J.arthur Trudeau Memorial Center Conversion Waivers	RI	Developmentally Disabled Services Day Training Agency	$0	$57.1M
Gateways To Change, Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$54.5M
Affinity Physicians LLC.	RI	Internal Medicine Physician	$0	$41.8M
J, Arthur Trudeau Memorial Center	RI	Developmentally Disabled Services Day Training Agency	$0	$33.9M

Everest Healthcare Rhode Island, Inc. — Billing Profile & Reimbursement Data

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Everest Healthcare Rhode Island, 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

Nearby Providers

Frequently Asked Questions

References