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.

Miguel Rivera (NPI 1831304112)

Field	Value
Entity Type	Individual
Organization	Miguel Rivera
Address	149 13th St
City	Charlestown
State	MA
ZIP	02129
Taxonomy	Molecular Genetic Pathology (Medical Genetics) Physician
NPI Enumerated	May 11, 2007

Payer Source	Total Paid
Medicare	$3.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0452	Molecular pathology procedure; physician interpretation and report	50	$40	$2K
88368	The lab analyst applies an initial in situ hybridization single probe stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a…	30	$40	$1.1K
88381	A clinician, typically a pathologist, performs a manual microdissection of a patient’s specimen, such as a biopsy or tissue preserved from a previous case.	40	$20	$760

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Massachusetts Distribution

Miguel Rivera — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0452	38	50	100	$40	$7.2K
88381	15	20	70	$40	$3.6K
88368	6	10	50	$30	$2.6K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Spaulding Rehabilitation Hospital Corporation	MA	Rehabilitation Hospital	$0	$54.8M
Adult Day Health, Inc.	MA	Adult Day Care Clinic/Center	$0	$13.4M
Melissa Colbert	MA	Physical Medicine & Rehabilitation Physician	$242.1K	$0
Michelle Kenny	MA	Family Medicine Physician	$188K	$0
Scott Homer	MA	Physical Medicine & Rehabilitation Physician	$127.7K	$0
M Arnaout	MA	Nephrology Physician	$45.6K	$0
Chloe Slocum	MA	Spinal Cord Injury Medicine Physician	$43.3K	$0

Miguel Rivera — Billing Profile & Reimbursement Data

Sign up for Miguel Rivera — Billing Profile & Reimbursement Data policy alerts

Miguel Rivera — Billing Profile & Reimbursement Data

Sign up for Miguel Rivera — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References