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.

Roger Williams Medical Center (NPI 1760736557)

Roger Williams Medical Center is a surgical oncology physician provider located in Providence, Rhode Island. This profile covers 0 Medicare and 43 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	Roger Williams Medical Center
Address	825 Chalkstone Ave
City	Providence
State	RI
ZIP	02908
Taxonomy	Surgical Oncology Physician
NPI Enumerated	November 1, 2012

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	4,270	$400	$1.7M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	4,190	$400	$1.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,560	$400	$1M
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.	460	$910	$414.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	470	$300	$141.4K
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…	110	$910	$103.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	200	$400	$80.8K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	2,280	$10	$22.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	1,250	$20	$21.3K
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…	370	$50	$18.4K

Showing 1–10 of 43

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

Roger Williams Medical Center — 2 of 25 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	23	30	260	$60	$3.4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	23	50	330	$50	$2.7M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	16	280	290	$260	$296.3K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15	340	370	$200	$272.8K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	13	290	180	$170	$224.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	47	70	360	$90	$154.9K
84100	The lab analyst performs a test to evaluate the level of phosphate, which is phosphorus not contained in biological compounds, in a patient specimen such as serum.	28	30	340	$70	$140.6K
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…	8	20	110	$460	$140.3K
85610	Prothrombin time is most commonly measured using the blood plasma. Chemicals like calcium and tissue factor are added to the plasma sample and then the time is noted when the plasma clots. To analyze…	18	30	850	$30	$132K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	19	100	70	$40	$129K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prospect Chartercare Rwmc, LLC	RI	General Acute Care Hospital	$0	$57.1M
Thomas Defanti	CT	Addiction Medicine (Psychiatry & Neurology) Physician	$0	$3.6M
Prospect Chartercare Rwmc, LLC	RI	Internal Medicine Physician	$0	$2.4M
Sajid Siddiq	RI	Cardiovascular Disease Physician	$300.6K	$19.3K
Joseph Mazza	RI	Cardiovascular Disease Physician	$268.7K	$15.2K
Florian Koci	RI	Cardiovascular Disease Physician	$268.6K	$4.4K
Anila Peter-faherty	RI	Cardiovascular Disease Physician	$233K	$10.9K
Neal Kelley	RI	Cardiovascular Disease Physician	$173.2K	$32K
Rodrigo Nardi	RI	Psychiatry Physician	$173.5K	$31.1K
Ali Akhtar	RI	Internal Medicine Physician	$61.5K	$134.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A Caring Experience Nursing Services, Inc.	RI	Home Health Agency	$0	$78.5M
Caregiver Homes Of Rhode Island Inc.	RI	Case Management Agency	$0	$43.4M
John Ricci	RI	Dentist	$0	$4.3M
Meals On Wheels Of Ri, Inc.	RI	Case Manager/Care Coordinator	$0	$4.1M
Professional Ambulance LLC	RI	Ambulance	$1.7M	$1.4M
University Pathologists, LLC	RI	Anatomic Pathology Physician	$0	$2.9M
Antonio Barajas	RI	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.1M
Nakitta Noel	RI	Emergency Medicine Physician	$32.3K	$1.5M
Beth Toolan	RI	Pediatrics Physician	$0	$1.3M
Altug Koymen	RI	Obstetrics & Gynecology Physician	$0	$1.2M

Roger Williams Medical Center — Billing Profile & Reimbursement Data

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Roger Williams Medical Center — 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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