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.

Coastal Medical Associates (NPI 1932175684)

Coastal Medical Associates is a anesthesiology physician provider located in Weymouth, Massachusetts. This profile covers 0 Medicare and 53 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	Coastal Medical Associates
Address	55 Fogg Rd
City	Weymouth
State	MA
ZIP	02190
Taxonomy	Anesthesiology Physician
NPI Enumerated	February 23, 2006

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

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

53 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	67,180	$80	$5.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	25,690	$60	$1.5M
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…	24,350	$20	$560.1K
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…	16,150	$30	$549K
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…	6,520	$80	$502.3K
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…	4,040	$70	$274.9K
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…	6,230	$40	$224.4K
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…	5,500	$40	$208.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,640	$60	$147.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3,280	$30	$105K

Showing 1–10 of 53

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

Coastal Medical Associates — 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

53 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	19	520	120	$130	$1M
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.	139	550	110	$120	$865.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	58	830	130	$120	$671K
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…	1,615	1,620	580	$80	$599.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	87	120	200	$180	$352.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	867	1,020	460	$100	$293.7K
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…	64	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,…	201	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…	475	5,040	200	$70	$209.5K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	24	100	590	$100	$203K

Showing 1–10 of 53

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raju Singla	MA	Internal Medicine Physician	$632.7K	$0
Michael Ayers	MA	Orthopaedic Surgery Physician	$484.8K	$0
Julius Tabe	MA	Family Medicine Physician	$449.6K	$2.5K
Helen Moreira	MA	Ophthalmology Physician	$443.3K	$0
Casey O'donnell	MA	Physical Medicine & Rehabilitation Physician	$406.9K	$0
Pushkar Kanade	OH	Internal Medicine Physician	$392.4K	$0
John Stevenson	MA	Internal Medicine Physician	$390.5K	$0
Brian Dolan	MA	Internal Medicine Physician	$338.2K	$0
Anthony Marks	MA	Interventional Cardiology Physician	$331.7K	$200
Wendy Johnson	MA	Cardiovascular Disease Physician	$325.5K	$80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Shore Hospital Inc.	MA	General Acute Care Hospital	$0	$95.1M
Jennifer Byer	MA	Medical Oncology Physician	$3.5M	$0
Shields Imaging Of Eastern Massachusetts LLC	MA	Mobile Radiology Clinic/Center	$2.7M	$774.1K
Harbor Medical Associates, Inc.	MA	Clinical Medical Laboratory	$1.8M	$420.7K
New England Eye Surgical Center Inc	MA	Ophthalmologic Surgery Clinic/Center	$1.8M	$271.1K
Harbor Medical Associates, Inc.	MA	Diagnostic Radiology Physician	$753K	$191K
Weymouth Endoscopy, LLC	MA	Endoscopy Clinic/Center	$844.3K	$4.7K
Patricia Hopkins	MA	Internal Medicine Physician	$733.6K	$0
George Kroumpouzos	MA	Dermatology Physician	$721.7K	$0
Harbor Medical Associates, Inc.	MA	Diagnostic Radiology Physician	$620.5K	$0

Coastal Medical Associates — Billing Profile & Reimbursement Data

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Coastal Medical Associates — 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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