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.

Kristen Spencer (NPI 1689040263)

Field	Value
Entity Type	Individual
Organization	Kristen Spencer
Address	25 Blackstone Valley Pl Ste 302
City	Lincoln
State	RI
ZIP	02865
Taxonomy	Clinical Social Worker
NPI Enumerated	August 18, 2015

Payer Source	Total Paid
Medicaid	$338.5K
Medicare	$0

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
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	6,430	$40	$231.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,300	$70	$85.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	250	$70	$18.5K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	30	$110	$2.8K

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

Kristen Spencer — 1 of 4 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
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	169	750	330	$70	$92.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	191	360	280	$90	$86.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	219	290	60	$110	$33.5K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	2	100	130	$30	$25.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seven Hills Rhode Island Inc	RI	Developmentally Disabled Services Day Training Agency	$0	$84.1M
Fellowship Health Resources, Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$49.1M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$31M
Seven Hills Rhode Island Inc	RI	In Home Supportive Care Agency	$0	$22M
Mohammad Suhail	RI	Internal Medicine Physician	$126.3K	$16M
Seven Hills Rhode Island Inc	RI	Multi-Specialty Clinic/Center	$0	$9.8M
Caregivers Ri, LLC	RI	Home Health Agency	$0	$8.5M
Epoch Sleep Centers, LLC	RI	Sleep Disorder Diagnostic Clinic/Center	$88.3K	$3.8M
Anchor Medical Associates	RI	General Practice Physician	$0	$2.9M
Golden Roads Adult Day Center LLC	RI	Adult Day Care Clinic/Center	$0	$2.3M

Kristen Spencer — Billing Profile & Reimbursement Data

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Kristen Spencer — 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