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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Prospect Chartercare Sjhsri, LLC (NPI 1871918870)

Field	Value
Entity Type	Organization
Organization	Prospect Chartercare Sjhsri, LLC
Address	200 High Service Ave
City	North Providence
State	RI
ZIP	02904
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 27, 2014

Payer Source	Total Paid
Medicaid	$10.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

208 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	3,720	$220	$802.7K
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…	23,110	$20	$531.5K
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.	1,390	$330	$457.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	12,060	$40	$446.3K
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.	15,070	$30	$391.8K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	9,510	$40	$361.3K
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…	14,380	$30	$359.4K
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.	17,120	$20	$342.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	1,120	$260	$286.4K
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…	4,270	$70	$286.2K

Showing 1–10 of 208

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Prospect Chartercare Sjhsri, LLC — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

208 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	7	30	260	$60	$3.4M
G0378	Hospital observation service, per hour	9	10	1,220	$1,410	$2.9M
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.	15	50	330	$50	$2.7M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	10	20	840	$210	$789.2K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2	10	300	$2,380	$723.1K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	10	20	660	$180	$475.3K
J2405	Injection, ondansetron hydrochloride, per 1 mg	8	20	1,080	$180	$470.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	13	10	270	$210	$419.8K
J0690	Injection, cefazolin sodium, 500 mg	7	10	100	$390	$339.8K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	9	20	280	$150	$330.2K

Showing 1–10 of 208

Related Providers

Other providers that share a Tax Identification Number (TIN) with Prospect Chartercare Sjhsri, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Joseph Health Services Of Ri	RI	General Acute Care Hospital	$0	$5.9M
Thomas Defanti	CT	Addiction Medicine (Psychiatry & Neurology) Physician	$0	$3.6M
Matthew Downey	RI	Pediatric Dentistry	$0	$2.8M
Chelsy Caren	RI	Obstetrics & Gynecology Physician	$0	$2.3M
John Kiang	RI	Pediatric Dentistry	$0	$1.3M
Daniel Kane	RI	Pediatric Dentistry	$0	$1.2M
Stephanie Avila	RI	Advanced Practice Midwife	$0	$1.1M
Yvonne Wolny	RI	Public Health Dentistry	$0	$1M
William Gordon	RI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1M
Nebyou Belay	RI	Child & Adolescent Psychiatry Physician	$3.2K	$997.5K

Nearby Providers

Other providers in the same ZIP code as Prospect Chartercare Sjhsri, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Providence Center Inc	RI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$170.9M
Re-focus Inc.	RI	Developmentally Disabled Services Day Training Agency	$0	$102.5M
Hopehealth Hospice & Palliative Care	RI	Community Based Hospice Care Agency	$0	$33.3M
Mas Medical Staffing	RI	Home Health Agency	$0	$24.5M
Generations Adult Day Health Center	RI	Adult Day Care Clinic/Center	$0	$16.3M
Global Homecare And Staffing Inc	RI	Home Health Agency	$0	$8.3M
Emergency Care Services Of New England PC	RI	Emergency Medicine Physician	$0	$6.9M
State Of Rhode Island	RI	Clinical Medical Laboratory	$570	$6.4M
The Providence Center	RI	Community/Behavioral Health Agency	$0	$5.9M
Darlington Memory Lane	RI	Assisted Living Facility	$0	$4.9M

Prospect Chartercare Sjhsri, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References