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.

Evans Medical Foundation, Inc. (NPI 1912954124)

Evans Medical Foundation, Inc. is a internal medicine physician provider located in Boston, Massachusetts. This profile covers 0 Medicare and 116 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	Evans Medical Foundation, Inc.
Address	1 Boston Medical Ctr Pl
City	Boston
State	MA
ZIP	02118
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$37.8M
Medicare	$0

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

116 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…	283,640	$40	$11.3M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	127,030	$50	$6.2M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	34,710	$100	$3.6M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	89,430	$30	$3M
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…	74,710	$30	$2.2M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	38,780	$50	$2.1M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	296,270	$10	$1.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	15,240	$100	$1.5M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	36,380	$30	$1.2M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	12,650	$50	$645K

Showing 1–10 of 116

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

Evans Medical Foundation, Inc. — 15 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

116 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99350	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…	3	30	90	$410	$2.1M
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.	25	120	530	$450	$681.5K
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…	42	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…	20	100	230	$600	$511.3K
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…	15	70	160	$620	$428.7K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	17	50	320	$530	$379.3K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	9	40	110	$570	$258.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1	230	380	$90	$256.4K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1	150	420	$110	$255K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	169	950	90	$100	$212.9K

Showing 1–10 of 116

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston Medical Center Corporation	MA	Community Health Clinic/Center	$0	$9.9M
Raphael Kieval	MA	Rheumatology Physician	$1.6M	$0
Syed Mahmood	MD	Medical Oncology Physician	$1M	$0
Kyu Kim	MA	Rheumatology Physician	$628.4K	$0
Gregory Johnson	MA	Internal Medicine Physician	$54.6K	$550.9K
Albert Daly	MA	Primary Podiatric Medicine Podiatrist	$462.1K	$0
Hong Jun Yun	IL	Interventional Cardiology Physician	$432.4K	$15.9K
Gary Rogers	FL	Dermatology Physician	$364.9K	$0
Anthony Litvak	MA	Interventional Cardiology Physician	$341.6K	$260
Brian Dalton	MA	Internal Medicine Physician	$341.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boston Medical Center Corporation	MA	General Acute Care Hospital	$0	$768.7M
Commonwealth Of Massachusetts	MA	Community/Behavioral Health Agency	$0	$153.7M
Boston Public Health Commission	MA	Ambulance	$5.9M	$67.6M
Boston Emergency Services Team (bupa) Boston	MA	Community/Behavioral Health Agency	$0	$59.2M
Boston Health Care For The Homeless Program, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$54.8M
Boston Health Care For The Homeless Program, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$53.1M
Boston University Psychiatry Associates, Inc.	MA	Psychiatry Physician	$0	$40.9M
Child Health Foundation Of Boston, Inc.	MA	Pediatrics Physician	$0	$26.6M
Boston Emergency Physician Foundation, Inc.	MA	Emergency Medicine Physician	$0	$24.3M
Volunteers Of America Of Massachusetts Inc	MA	Substance Abuse Rehabilitation Facility	$0	$21.4M

Evans Medical Foundation, 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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