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.

Reliant Medical Group, Inc (NPI 1720017528)

Key Findings

Field	Value
Entity Type	Organization
Organization	Reliant Medical Group, Inc
Address	5 Neponset St
City	Worcester
State	MA
ZIP	01606
Taxonomy	Family Medicine Physician
NPI Enumerated	July 2, 2006

Payer Source	Total Paid
Medicaid	$101.8M
Medicare	$0

RELlANT MEDICAL GROUP, INC reports no Medicare billing on file and instead generates its entire recorded federal payer revenue from Medicaid, with total Medicaid revenue of $101.8M. This makes the practice effectively single‑payer at the federal-program level and concentrates its exposure and reimbursement risk in Medicaid.

Revenue concentration is high: the top three Medicaid codes (99214, 99213, and 87636) together account for 55.0% of the provider’s total Medicaid revenue. The single largest line is 99214 ($25.5M, 30.0% of Medicaid revenue), followed by 99213 ($17.4M, 20.5%), indicating that office-based evaluation and management visits are the dominant revenue drivers.

Service‑line mix implied by the top codes points to a large, multi‑service ambulatory primary care operation with robust pediatric and preventive care activity plus ancillary diagnostics and therapy. High volumes in E/M codes 99214 and 99213 along with preventive visit codes (99391, 99392, 99393) and immunization codes (90460, 90461) indicate heavy primary care and pediatric preventive services, while substantial volumes in 97110, 97140, and 97530 suggest on‑site therapeutic/rehabilitation services are offered.

Competitive standing in Massachusetts is dominant for many Medicaid codes: 99214 ranks #11 of 5039 providers (100th percentile; extreme outlier) and 99213 ranks #7 of 5303 providers (100th percentile; extreme outlier), which signals far higher state volumes than typical primary care practices. The practice also ranks #1 for 90460 (1018 providers, 100th percentile) and 96110 (1137 providers, 100th percentile), reinforcing that it is a major statewide provider for pediatric immunizations and developmental screening.

Diagnostic and procedure lines show both typical and exceptional placements: 87636 (multiplex SARS‑CoV‑2/influenza testing) is $3.8M (4.5% of Medicaid revenue) and ranks #2 of 58 providers (98th percentile; extreme outlier), indicating unusually high lab testing volume for respiratory pathogen multiplex testing. Imaging and cardiology services (e.g., 77067, 93306, 76830) appear at meaningful but less extreme ranks, suggesting the organization provides or bills for a range of ancillary diagnostic services in addition to core primary care.

The provider’s long tenure—NPI enumerated on 2006-07-02 (~20 years ago)—aligns with the scale and breadth of services reported and supports the plausibility of sustained, high Medicaid volume over time. Established enrollment duration is consistent with the large claim counts reported across multiple high‑volume CPT codes.

Several codes are flagged as statistical outliers statewide across different service categories, which is operationally informative: codes labeled "extreme outlier" (for example 99214, 99213, 87636, 99392, 99391) reflect volumes far above typical peers, while other codes are described as "notably above typical" or "typical, unremarkable," indicating the provider’s dominance is concentrated in specific primary care, pediatric, screening, and therapy services rather than uniformly across all lines. This pattern suggests targeted strengths rather than a uniformly large presence in every Medicaid‑billable specialty.

For payer strategy and network planning, the takeaway is clear: RELIANT MEDICAL GROUP is a high‑volume Medicaid provider concentrated in primary care E/M and pediatric/preventive services, with notable ancillary therapy and testing capacity. Given the absence of Medicare billing, any partnerships, contracts, or risk arrangements should treat the entity as primarily Medicaid‑focused and evaluate capacity in the specific high‑volume codes (e.g., 99214, 99213, 87636) where it is an extreme outlier statewide.

Medicaid: Complete Services Breakdown

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

364 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	262,620	$100	$25.5M
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…	263,380	$70	$17.4M
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…	17,390	$220	$3.8M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	74,900	$40	$3.3M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	29,780	$110	$3.2M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	74,650	$40	$3M
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…	23,390	$120	$2.7M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	22,930	$110	$2.5M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	15,440	$150	$2.4M
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	50,980	$40	$2.1M

Showing 1–10 of 364

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

Reliant Medical Group, Inc — 19 of 25 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

364 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	19	30	90	$410	$2.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	29	50	1,870	$210	$1.4M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	42	80	4,380	$140	$1.1M
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	52	60	1,750	$260	$907.4K
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.	252	410	140	$110	$742.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	29	120	530	$450	$681.5K
J0585	Injection, onabotulinumtoxina, 1 unit	15	40	430	$490	$616K
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…	572	1,620	580	$80	$599.6K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	35	100	260	$550	$524.4K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	77	100	230	$600	$511.3K

Showing 1–10 of 364

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bryan Hong	MA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Brad Baker	MA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Frank Mccabe	MA	Retina Specialist (Ophthalmology) Physician	$1.5M	$0
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Tony Samaha	MA	Hematology & Oncology Physician	$813.5K	$0
Karen Jeng-miller	MA	Ophthalmology Physician	$698.7K	$0
Vincent Champion	NC	Diagnostic Radiology Physician	$406.6K	$166.9K
Bradley Switzer	MA	Internal Medicine Physician	$524.2K	$0
Miin Roh	MA	Ophthalmology Physician	$510.9K	$0
Ilsa Grunder	MA	Nurse Practitioner	$419.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Commonwealth Of Massachusetts	MA	Case Management Agency	$0	$282.1M
Massachusetts Rehabilitation Commission	MA	Community/Behavioral Health Agency	$0	$64.6M
Epic Health Services Inc	MA	Home Health Agency	$0	$49.7M
Elder Services Of Worcester Area, Inc	MA	Case Management Agency	$0	$48.3M
Youth Opportunities Upheld, Inc.	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$44.2M
Pediatric Services Of America, LLC	MA	Nursing Care Agency	$0	$29M
Abba Home Care, LLC	MA	Home Health Agency	$0	$18.9M
Vna Care Network, Inc.	MA	Home Health Agency	$0	$13.5M
Seven Hills Aspire, Inc.	MA	Respite Care	$0	$11.4M
Advocates, Inc	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.8M

Reliant Medical Group, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References