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 Massachusetts for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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.

Circle Health Urgent Care, LLC (NPI 1710392683)

Circle Health Urgent Care, LLC is a urgent care clinic/center provider located in Westford, Massachusetts. This profile covers 0 Medicare and 24 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	Circle Health Urgent Care, LLC
Address	198 Littleton Rd
City	Westford
State	MA
ZIP	01886
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	June 30, 2014

Payer Source	Total Paid
Medicaid	$5.9M
Medicare	$0

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	17,090	$120	$2M
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…	25,220	$70	$1.7M
99203	The provider sees a new 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 provider…	9,560	$70	$650.1K
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…	8,390	$50	$419.6K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	4,580	$70	$311.2K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	9,070	$30	$235.8K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	2,520	$90	$234.2K
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…	1,150	$100	$117.5K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	4,390	$20	$96.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	4,320	$20	$64.8K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Massachusetts providers billing the same CPT/HCPCS codes.

Claims Volume vs. Massachusetts Distribution

Circle Health Urgent Care, LLC — 4 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	47	130	1,830	$60	$974.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	53	410	140	$110	$742.2K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	12	30	1,140	$60	$598K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	3	60	200	$120	$310K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	441	950	90	$100	$212.9K
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…	95	5,040	200	$70	$209.5K
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…	318	670	120	$100	$169.2K
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…	299	5,300	230	$60	$164.5K
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	36	100	1,930	$20	$155.5K
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…	111	870	90	$100	$82K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Derry Medical Center, PA	NH	Family Medicine Physician	$0	$2.4M
Eric Benson	NH	Orthopaedic Surgery Physician	$824.5K	$0
Concord Orthopaedics Professional Association	NH	Orthopaedic Surgery Physician	$0	$646.8K
Stephen Kelly	MA	Orthopaedic Surgery Physician	$379.3K	$110.9K
Michael Ayers	MA	Orthopaedic Surgery Physician	$484.8K	$0
Geoffrey Van Flandern	MA	Orthopaedic Surgery Physician	$408.1K	$0
Andrew Lehman	MA	Orthopaedic Surgery Physician	$370.3K	$4.8K
Alexander Brothers	MA	Orthopaedic Surgery Physician	$328.3K	$22K
James Nairus	MA	Orthopaedic Surgery Physician	$339.8K	$0
Michael Marchetti	MA	Orthopaedic Surgery Physician	$323.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nupath Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$7.5M
Millennium Home Adult Day Healthcare	MA	Adult Day Care Clinic/Center	$0	$7.2M
Benjamin Solky	MA	MOHS-Micrographic Surgery Physician	$1.5M	$0
Steven Franks	MA	Dermatology Physician	$426.2K	$787.4K
Town Of Westford	MA	Ambulance	$295.1K	$309.7K
Dwayne Baharozian	MA	Specialist	$395.5K	$920
Calin Vasiliu	MA	Surgery Physician	$154.8K	$0
James Cohen	MA	Internal Medicine Physician	$102.6K	$0
Janine Jones	MA	Nurse Practitioner	$90.9K	$0
Kristen Mccarthy	MA	Family Medicine Physician	$65K	$0

Circle Health Urgent Care, LLC — Billing Profile & Reimbursement Data

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Circle Health Urgent Care, LLC — 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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