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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Mid-state Health Center (NPI 1811156409)

Field	Value
Entity Type	Organization
Organization	Mid-state Health Center
Address	101 Boulder Point Dr
City	Plymouth
State	NH
ZIP	03264
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 9, 2008

Payer Source	Total Paid
Medicaid	$80.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	260	$120	$31.5K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	1,260	$20	$18.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	610	$20	$14.1K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	860	$10	$6.9K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	80	$50	$4.2K
0011A	N/A	50	$30	$1.6K
0124A	N/A	20	$40	$760
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.	180	$1	$700
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…	100	$10	$580
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.	70	$10	$530

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Mid-state Health Center — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	50	80	760	$170	$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…	327	420	480	$50	$223.9K
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…	376	400	350	$30	$140.6K
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.	35	40	10,940	$10	$90K
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…	37	40	6,520	$1	$58.9K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	35	40	2,600	$10	$46.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	27	30	520	$50	$40.7K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	32	30	2,420	$10	$39.6K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	10	40	680	$20	$28.4K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	40	40	1,340	$10	$27.5K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mid-state Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$5.5M
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$3.3M
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$77.6K
Mid-state Health Center	NH	Federally Qualified Health Center (FQHC)	$0	$74.7K
David Fagan	NH	Internal Medicine Physician	$62.1K	$0
Matthew Scagliarini	NH	Physical Therapist	$49.8K	$0
Kathleen Mackay	NH	Physical Therapist	$44.6K	$0
Leesa Conway	NH	Physical Therapist	$36.4K	$0
Pamela Hixon	NH	Occupational Therapist	$30.2K	$0
Devan Rooney	NH	Family Nurse Practitioner	$13.6K	$530

Nearby Providers

Other providers in the same ZIP code as Mid-state Health Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mount Prospect Academy, Inc.	NH	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$76.6M
Speare Memorial Hospital	NH	Critical Access Hospital	$0	$9.2M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$6.4M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$1.1M
Speare Memorial Hospital	NH	Rural Health Clinic/Center	$0	$817.5K
Speare Health Ventures, Inc.	NH	Urgent Care Clinic/Center	$0	$388.4K
Paul Musco	NH	Ophthalmology Physician	$337K	$0
Pemi Baker Regional School District	NH	Local Education Agency (LEA)	$0	$318K
Plymouth School District	NH	Local Education Agency (LEA)	$0	$312.5K
Pemi-baker Hospice & Home Health	NH	Home Health Agency	$0	$298.5K

Mid-state Health Center — Billing Profile & Reimbursement Data

Sign up for Mid-state Health Center — Billing Profile & Reimbursement Data policy alerts

Mid-state Health Center — Billing Profile & Reimbursement Data

Sign up for Mid-state Health Center — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References