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

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

Northbay Healthcare Group (NPI 1780736736)

Northbay Healthcare Group is a addiction medicine (psychiatry & neurology) physician provider located in Fairfield, California. This profile covers 0 Medicare and 162 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	Northbay Healthcare Group
Address	1860 Pennsylvania Ave Ste 230
City	Fairfield
State	CA
ZIP	94533
Taxonomy	Addiction Medicine (Psychiatry & Neurology) Physician
NPI Enumerated	January 18, 2007

Payer Source	Total Paid
Medicaid	$32.7M
Medicare	$0

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

162 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	71,120	$100	$7.3M
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.	33,560	$140	$4.8M
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…	113,160	$30	$3.6M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	14,500	$130	$1.9M
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.	28,980	$60	$1.8M
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…	33,480	$50	$1.6M
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…	78,790	$10	$1.1M
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…	12,290	$90	$1.1M
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…	6,100	$170	$1M
J0585	Injection, onabotulinumtoxina, 1 unit	970	$900	$866.5K

Showing 1–10 of 162

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Northbay Healthcare Group — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

162 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	168	1,570	680	$110	$1.1M
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.	118	1,300	510	$100	$943K
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.	60	1,400	470	$80	$884.5K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	247	250	800	$110	$625.7K
J0585	Injection, onabotulinumtoxina, 1 unit	29	110	260	$590	$407.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	886	960	1,820	$50	$351.9K
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…	200	280	730	$90	$315.5K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	143	310	190	$100	$301.4K
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…	118	1,080	460	$110	$263.5K
97139	Use 97139 to report therapeutic procedures that do not have a specific code.	71	290	2,010	$20	$243.3K

Showing 1–10 of 162

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northbay Healthcare Group	CA	General Acute Care Hospital	$0	$64.9M
Northbay Physicians Surgery Center LLC	CA	Ambulatory Surgical Clinic/Center	$1.3M	$2.9M
Patrick Gonzales	CA	Vascular & Interventional Radiology Physician	$2.7M	$0
Clark Tsai	CA	Ophthalmology Physician	$891.3K	$52.2K
Shilpa Puppala	IL	Diagnostic Radiology Physician	$864.2K	$0
Patrick Ryan	CA	Diagnostic Radiology Physician	$722.4K	$0
Jeffrey Goletz	CA	Diagnostic Radiology Physician	$711.9K	$0
Kathryn Amacher	CA	Geriatric Medicine (Internal Medicine) Physician	$496.9K	$55.9K
Sunil Gandhi	CA	Diagnostic Radiology Physician	$551.9K	$0
Ameer Almullahassani	CA	Neurology Physician	$504.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Solano	CA	Public Health or Welfare Agency	$0	$200.6M
County Of Solano	CA	State or Local Public Health Clinic/Center	$0	$35.2M
County Of Solano	CA	Federally Qualified Health Center (FQHC)	$0	$23.6M
Medmark Treatment Centers - Fairfield, Inc.	CA	Methadone Clinic	$445.7K	$1.4M
Gurinder Dhillon	CA	Cardiovascular Disease Physician	$286K	$0
Shahid Rehman	CA	Neurology Physician	$261.4K	$0
William Fulton	CA	Surgery Physician	$93.6K	$0
James Bronk	CA	Diagnostic Radiology Physician	$85.8K	$0
Steven Siegal	CA	Specialist	$45.4K	$0
Christopher Rumery	CA	Anesthesiology Physician	$42K	$0

Northbay Healthcare Group — Billing Profile & Reimbursement Data

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Northbay Healthcare Group — 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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