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.

Michael Forman (NPI 1639260276)

Field	Value
Entity Type	Individual
Organization	Michael Forman
Address	2000 Diamond Hill Rd
City	Woonsocket
State	RI
ZIP	02895
Taxonomy	General Practice Dentistry
NPI Enumerated	September 27, 2006

Payer Source	Total Paid
Medicaid	$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.

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	5,670	$40	$215.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	2,600	$70	$174.3K
D1208	Topical application of fluoride - excluding varnish	4,800	$20	$105.6K
D0330	N/A	2,270	$50	$102.1K
D0120	Periodic oral evaluation - established patient	5,000	$10	$70K
D2394	N/A	760	$80	$59.7K
D2335	N/A	690	$80	$55.4K
D0272	N/A	2,690	$20	$45.8K
D0140	Limited oral evaluation – problem focused	1,660	$20	$38.1K
D2954	N/A	250	$130	$32.6K

Showing 1–10 of 25

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

Michael Forman — 2 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	14	30	350	$110	$158.2K
D2332	N/A	6	10	100	$70	$124.1K
D1120	Prophylaxis–child	158	160	710	$30	$91.2K
D2954	N/A	7	10	420	$150	$66.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	13	100	510	$50	$65.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	19	180	490	$20	$42.3K
D0120	Periodic oral evaluation - established patient	28	210	930	$10	$38.1K
D1208	Topical application of fluoride - excluding varnish	8	100	290	$20	$32.1K
D2394	N/A	1	10	390	$80	$30.9K
D0330	N/A	8	100	400	$40	$30.7K

Showing 1–10 of 25

Nearby Providers

Other providers in the same ZIP code as Michael Forman, ranked by combined Medicare and Medicaid revenue.

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
Thundermist Health Center	RI	Dental Clinic/Center	$0	$18.6M
Thundermist Health Center	RI	Federally Qualified Health Center (FQHC)	$0	$15.8M
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
Beata Nelken	RI	Pediatrics Physician	$0	$4.2M
Tmed Holdings, Inc.	RI	Durable Medical Equipment & Medical Supplies	$0	$3.8M

Michael Forman — Billing Profile & Reimbursement Data

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Michael Forman — 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