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.

Riverbend Medical Group, Inc. (NPI 1841651197)

Riverbend Medical Group, Inc. is a internal medicine physician provider located in Springfield, Massachusetts. This profile covers 0 Medicare and 276 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	Riverbend Medical Group, Inc.
Address	271 Carew St
City	Springfield
State	MA
ZIP	01104
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 15, 2016

Payer Source	Total Paid
Medicaid	$38.8M
Medicare	$0

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

276 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	281,440	$50	$14.1M
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…	190,130	$40	$7.4M
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.	46,310	$30	$1.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	19,230	$60	$1.2M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	19,420	$60	$1.1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	18,290	$60	$1.1M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	12,920	$80	$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…	10,910	$90	$938.6K
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…	14,620	$50	$774.6K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	76,580	$10	$765.8K

Showing 1–10 of 276

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Riverbend Medical Group, Inc. — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

276 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	41	410	140	$110	$742.2K
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.	41	120	530	$450	$681.5K
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.	306	370	500	$40	$605.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	335	1,620	580	$80	$599.6K
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…	46	100	260	$550	$524.4K
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…	29	100	230	$600	$511.3K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	186	220	280	$100	$491.2K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	25	70	160	$620	$428.7K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	68	120	200	$180	$352.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	190	230	330	$70	$343.3K

Showing 1–10 of 276

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Roy Bryan	CA	Diagnostic Radiology Physician	$417.1K	$90
Rachel Nelson	TN	Diagnostic Radiology Physician	$383.2K	$0
Michael Chill	MA	Diagnostic Radiology Physician	$372.2K	$410
Sean Snodgress	CA	Neuroradiology Physician	$323K	$100
Krishnan Babu	MA	Nephrology Physician	$289.3K	$0
Scott White	IL	Diagnostic Radiology Physician	$264.9K	$0
Anne Morris	MA	Diagnostic Radiology Physician	$254.1K	$0
Kevin Marcum	FL	Diagnostic Radiology Physician	$243.6K	$0
Jennie Garver	MA	Orthopaedic Surgery Physician	$185.9K	$49.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health Network Inc	MA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$238.6M
Gandara Mental Health Center Inc	MA	Mental Health Counselor	$0	$133.1M
Behavioral Health Network, Inc	MA	Methadone Clinic	$1.3M	$108.4M
The Mercy Hospital Inc	MA	General Acute Care Hospital	$0	$98.9M
Behavioral Health Network, Inc	MA	Adult Day Care Clinic/Center	$0	$76.5M
American Medical Response Of Massachusetts Inc	MA	Ambulance	$8.7M	$51.7M
Greater Springfield Senior Services, Inc.	MA	Case Management Agency	$0	$55.1M
Viability, Inc.	MA	Adult Care Home Facility	$0	$46.8M
International Health Solutions,inc	MA	Home Health Agency	$0	$27.3M
Greater Springfield Senior Services, Inc.	MA	Case Management Agency	$0	$25.4M

Riverbend Medical Group, Inc. — Billing Profile & Reimbursement Data

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Riverbend Medical Group, Inc. — 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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