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 New Hampshire for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Specialty Institute PLLC (NPI 1932833621)

Specialty Institute PLLC is a interventional pain medicine physician provider located in Newington, New Hampshire. This profile covers 0 Medicare and 19 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	Specialty Institute PLLC
Address	101 Shattuck Way Ste 6
City	Newington
State	NH
ZIP	03801
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	July 11, 2022

Payer Source	Total Paid
Medicaid	$142.3K
Medicare	$0

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

19 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…	2,810	$30	$87.1K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	2,160	$10	$19.4K
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…	520	$20	$8.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1,750	$1	$7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	910	$10	$6.4K
J1010	Injection, methylprednisolone acetate, 1 mg	200	$30	$4.9K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	140	$30	$3.5K
20553	Trigger point injection, or TPI, is a medical procedure in which the provider injects an anesthetic or corticosteroid substance into three or more muscles to relieve painful areas or knots in muscles…	100	$20	$2.3K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	60	$20	$1.2K
G3002	Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation,…	730	$1	$730

Showing 1–10 of 19

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Specialty Institute PLLC — 4 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	67	130	520	$50	$338.8K
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…	112	420	480	$50	$223.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	4	10	30	$220	$208.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	14	40	870	$10	$23.1K
20553	Trigger point injection, or TPI, is a medical procedure in which the provider injects an anesthetic or corticosteroid substance into three or more muscles to relieve painful areas or knots in muscles…	4	10	140	$70	$16.3K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	12	50	370	$10	$8.1K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	1	10	110	$10	$3.9K
76942	Ultrasonography uses sound waves of higher frequencies (above the normal hearing capacity of a healthy human, i.e., 20 kHz) to visualize inner organs. When the sound waves pass through the human…	1	10	50	$50	$2.9K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	21	40	630	$1	$2.3K
J1040	Injection, methylprednisolone acetate, 80 mg	4	10	140	$1	$1.8K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Region Viii, One Sky Community Services Inc.	NH	Case Management Agency	$0	$192.2M
Novocure Inc.	NH	Durable Medical Equipment & Medical Supplies	$0	$113.1M
Seacoast Mental Health Center, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$74.2M
Hca Health Services Of New Hampshire Inc	NH	General Acute Care Hospital	$0	$18.8M
Pmc Medical Group, LLC	NH	General Practice Physician	$392K	$11.2M
Greater Seacoast Community Health	NH	Federally Qualified Health Center (FQHC)	$0	$6.6M
Kinley Beck	NH	Retina Specialist (Ophthalmology) Physician	$4.2M	$0
Portsmouth School Department	NH	Local Education Agency (LEA)	$0	$2.6M
Preferred Home Health Care And Nursing Services	NH	Durable Medical Equipment & Medical Supplies	$0	$2.3M
Watterworth Orthodontics, PA	NH	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$2.3M

Specialty Institute PLLC — Billing Profile & Reimbursement Data

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Specialty Institute PLLC — 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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