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.

Roger Epstein (NPI 1821095183)

Field	Value
Entity Type	Individual
Organization	Roger Epstein
Address	21 Clark Way
City	Somersworth
State	NH
ZIP	03878
Taxonomy	Gastroenterology Physician
NPI Enumerated	July 1, 2005

Payer Source	Total Paid
Medicare	$347.8K
Medicaid	$0

Key Findings

This provider’s lifetime activity is effectively single-payer: total Medicare revenue is $347.8K and there is no Medicaid billing on file, indicating the practice bills Medicare but has no recorded Medicaid revenue. Analysts should treat the profile as Medicare-dominated when evaluating payer mix or access implications.

Revenue is highly concentrated in a handful of services: the precomputed top 3 Medicare codes by revenue account for 79.9% of the provider’s total Medicare revenue, driven primarily by J3380 (56.4%), 45385 (15.3%), and 99213 (8.1%). This concentration means most revenue exposure and utilization risk is tied to infusion and endoscopy/E&M activity.

The code mix points to an integrated gastroenterology practice that combines biologic infusion services with endoscopic procedures and office visits. J3380 (11.4K claims, $17 avg paid/claim, $193.8K revenue) indicates substantial vedolizumab infusion activity, while 45385 (257 claims, $205 avg paid/claim, $52.7K revenue) and other colonoscopy codes reflect polypectomy and diagnostic endoscopy as meaningful procedural lines alongside frequent E/M visits such as 99213 (442 claims, $63 avg paid/claim, $27.8K revenue).

Competitive standing varies by code: J3380 ranks #194 of 620 providers nationally (68th percentile; typical, unremarkable volume), so the provider is modestly above median for vedolizumab infusion but not dominant. In contrast, 45385 ranks #874 of 16310 providers (95th percentile; typical, unremarkable volume) and 99213 ranks #33376 of 457151 providers (93th percentile; typical, unremarkable volume), suggesting relatively high national relative volume for colonoscopic polypectomy and common E/M visits despite the reports labeling volumes as "typical, unremarkable."

Operational support codes corroborate the endoscopy-plus-infusion model: G0500 moderate sedation appears on 168 claims ($4 avg paid/claim, $672 revenue) which aligns with endoscopic procedures, while infusion administration (96365, 38 claims, $49 avg paid/claim, $1.9K revenue) and supplies (J7050 appears but shows $0 revenue) further indicate mixed infusion and procedural workflows. These ancillary codes are small contributors to revenue but are consistent with performing sedated endoscopy and in-office infusions.

The provider has longstanding Medicare enrollment (NPI enumerated 2005-07-01, ~21 years ago), signaling an established practice in the market; that tenure, paired with the high share of revenue from J3380 and 45385, implies a stable, procedure- and infusion-focused gastroenterology operation. Analysts evaluating market share or continuity of care should account for this multi-decade presence.

There is heterogeneity across lower-revenue codes: several diagnostic or less-frequent procedure codes (for example, 45378 with 12 claims, $124 avg paid/claim, $1.5K revenue) rank low in national percentiles (45378 at the 6th percentile) while other routine diagnostics (e.g., 43239, 93 claims, $69 avg paid/claim, $6.4K revenue) sit closer to mid-percentiles. This spread indicates the practice concentrates volume in a few high-revenue services while maintaining occasional use of a broader set of gastroenterology procedures and diagnostics.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3380	Injection, vedolizumab, intravenous, 1 mg	11,400	$20	$193.8K
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…	260	$210	$52.7K
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…	440	$60	$27.8K
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…	170	$90	$14.8K
G0105	Colorectal cancer screening; colonoscopy on individual at high risk	70	$180	$11.4K
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.	90	$70	$6.4K
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…	60	$120	$6.4K
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…	70	$70	$5.4K
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…	40	$110	$4.4K
G0121	Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk	20	$180	$3.2K

Showing 1–10 of 21

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Hampshire Distribution

Roger Epstein — 2 of 20 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. state median

21 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3380	1	10	8,100	$20	$147.6K
45385	7	100	80	$250	$26.5K
99214	1,127	3,150	110	$80	$13.2K
45380	45	90	50	$150	$10.7K
99232	684	990	70	$60	$9.8K
G0105	13	60	30	$230	$9.4K
43239	29	90	70	$100	$7.7K
99213	127	2,900	70	$50	$6.9K
G0121	33	50	20	$240	$6.2K
43249	19	40	20	$170	$5.6K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with Roger Epstein, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sean Lynch	NH	Gastroenterology Physician	$320.2K	$0
Atlantic Digestive Specialists, PLLC	NH	Gastroenterology Physician	$0	$312.2K
Aristotle Damianos	NH	Gastroenterology Physician	$273.2K	$0
Robert Ruben	NH	Specialist	$201.4K	$0
William Maher	NH	Gastroenterology Physician	$200.3K	$0
Brian Hyett	NH	Internal Medicine Physician	$189.8K	$0
Shelby Menard	NH	Nurse Practitioner	$152.3K	$0
Khushboo Munot	NH	Gastroenterology Physician	$118.6K	$0
Jennifer Lewis	NH	Gastroenterology Physician	$107.1K	$0
Sukeerti Kesar	NH	Gastroenterology Physician	$92.8K	$0

Nearby Providers

Other providers in the same ZIP code as Roger Epstein, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greater Seacoast Community Health	NH	Federally Qualified Health Center (FQHC)	$0	$21.2M
Strafford Nutrition & Meals On Wheels	NH	Home Health Agency	$0	$1.8M
Sau 56	NH	Local Education Agency (LEA)	$0	$728.1K
Gregory Aprilliano	NH	Certified Registered Nurse Anesthetist	$0	$478K
Wentworth Surgery Center, LLC	NH	Ambulatory Surgical Clinic/Center	$406.2K	$0
Ira Parsons	NH	Orthopaedic Surgery Physician	$318.8K	$0
Tri City Counseling	NH	Multi-Specialty Clinic/Center	$0	$198.6K
Joseph Konopka	NH	Orthopaedic Surgery Physician	$174.9K	$0
David Thut	NH	Sports Medicine (Orthopaedic Surgery) Physician	$163.2K	$0
Adam Fleit	NH	Orthopaedic Hand Surgery Physician	$131.2K	$0

Roger Epstein — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References