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.

Brown Medicine (NPI 1689626764)

Brown Medicine is a internal medicine physician provider located in Riverside, Rhode Island. This profile covers 0 Medicare and 35 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	Brown Medicine
Address	375 Wampanoag Trl
City	Riverside
State	RI
ZIP	02915
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 17, 2006

Payer Source	Total Paid
Medicaid	$351K
Medicare	$0

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	670	$160	$109.9K
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…	11,200	$10	$78.4K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,250	$20	$78K
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…	6,450	$10	$32.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9,950	$1	$19.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	3,500	$1	$10.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	6,460	$1	$6.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1,860	$1	$3.7K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	20	$140	$2.4K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2,060	$1	$2.1K

Showing 1–10 of 35

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

Brown Medicine — 6 of 20 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

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	2	10	620	$1,180	$1.1M
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	9	10	280	$140	$90.9K
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…	31	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…	61	2,050	300	$50	$72.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	33	160	90	$110	$54.6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2	30	170	$110	$51.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4	100	70	$50	$42.2K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	12	10	140	$10	$41.2K
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…	62	300	50	$130	$40.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	170	80	$40	$40.3K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Edward Medeiros	RI	Nephrology Physician	$87.2K	$6.8M
Susie Hu	RI	Nephrology Physician	$30.9K	$911.1K
Joseph Garland	RI	Infectious Disease Physician	$17.4K	$743.1K
Gabrielle Burke	RI	Family Nurse Practitioner	$3.6K	$439.4K
Brown Medicine	RI	Ambulatory Surgical Clinic/Center	$218.5K	$0
Franklin Mccool	RI	Pulmonary Disease Physician	$56.2K	$102.6K
Valerie Thomas	RI	Endocrinology, Diabetes & Metabolism Physician	$131.6K	$40
Thomas Sepe	RI	Gastroenterology Physician	$100K	$29.4K
Jason Aliotta	RI	Pulmonary Disease Physician	$40.3K	$63.9K
Debasree Banerjee	RI	Pulmonary Disease Physician	$34.3K	$67.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emma Pendleton Bradley Hospital	RI	Psychiatric Hospital	$0	$37.6M
East Bay Community Action Program	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$20.5M
Emma Pendleton Bradley Hospital	RI	Psychiatric Hospital	$0	$5M
Health Care Connections Nursing Services, Inc	RI	Home Health Agency	$0	$3.6M
City Of East Providence	RI	Local Education Agency (LEA)	$0	$2.2M
East Bay Community Action Program	RI	Community/Behavioral Health Agency	$0	$2.2M
East Bay Community Action Program	RI	Community Health Clinic/Center	$0	$1.5M
Amerita Inc	RI	Home Infusion Therapy Pharmacy	$0	$1.1M
Care Resource, LLC	RI	Home Health Agency	$0	$1.1M
City Of East Providence	RI	Local Education Agency (LEA)	$0	$768.1K

Brown Medicine — Billing Profile & Reimbursement Data

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Brown Medicine — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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