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.

Western Mass Physician Associates Inc (NPI 1922009547)

Western Mass Physician Associates Inc is a obstetrics & gynecology physician provider located in Chicopee, Massachusetts. This profile covers 0 Medicare and 80 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	Western Mass Physician Associates Inc
Address	262 New Ludlow Rd
City	Chicopee
State	MA
ZIP	01020
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	August 4, 2005

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

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

80 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	62,400	$40	$2.2M
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…	46,460	$50	$2.1M
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	3,910	$60	$250.5K
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.	5,040	$30	$125.9K
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	1,540	$60	$90.9K
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…	1,560	$60	$90.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,510	$50	$75.3K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,120	$60	$70.8K
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…	960	$70	$70.1K
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…	5,680	$10	$62.4K

Showing 1–10 of 80

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

Western Mass Physician Associates Inc — 2 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

80 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1502	Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit	95	130	34,780	$60	$7.4M
G0299	Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each 15 minutes	261	310	8,710	$40	$1.6M
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.	128	410	140	$110	$742.2K
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.	299	370	500	$40	$605.1K
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…	147	200	450	$30	$511.5K
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,…	678	950	90	$100	$212.9K
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…	58	5,040	200	$70	$209.5K
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…	253	670	120	$100	$169.2K
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…	35	5,300	230	$60	$164.5K
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…	108	550	160	$90	$122.2K

Showing 1–10 of 80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Child Health Foundation Of Boston, Inc.	MA	Pediatrics Physician	$0	$26.6M
Sidney Kahn Iv	MA	Vascular & Interventional Radiology Physician	$945K	$0
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Margo Moskos	MA	Diagnostic Radiology Physician	$717.3K	$137.9K
Rachel Nelson	TN	Diagnostic Radiology Physician	$383.2K	$0
Michael Chill	MA	Diagnostic Radiology Physician	$372.2K	$410
Alexander Harvin	IA	Diagnostic Radiology Physician	$353.1K	$0
Alice Mary Graham-brown	MA	Psychiatry Physician	$155.1K	$118.4K
Scott White	IL	Diagnostic Radiology Physician	$264.9K	$0
Mansoor Zaidi	MA	Internal Medicine Physician	$147.4K	$114.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Dentistry Of Chicopee	MA	Dentist	$0	$13.4M
Children's Dentistry And Orthodontics Of Chicopee 1 LLC	MA	Dentist	$0	$11.3M
Sunshine Village, Inc.	MA	Developmentally Disabled Services Day Training Agency	$0	$10.5M
Sunshine Village, Inc	MA	Developmentally Disabled Services Day Training Agency	$0	$9M
City Of Chicopee	MA	Land Ambulance	$899.6K	$4.8M
Anne Shain	MA	Internal Medicine Physician	$178.5K	$5.7K
Zhongmo Yu	MA	Internal Medicine Physician	$116.4K	$10K
Jill Roach	MA	Physical Therapist	$74.2K	$0
Oyinkansola Ogundipe	MA	Family Medicine Physician	$54.5K	$0
Diane Alpern	MA	Registered Dietitian	$11.9K	$0

Western Mass Physician Associates 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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