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.

South County Hospital Healthcare System (NPI 1952366106)

Field	Value
Entity Type	Organization
Organization	South County Hospital Healthcare System
Address	100 Kenyon Ave
City	Wakefield
State	RI
ZIP	02879
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 19, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

130 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	1,930	$400	$771.6K
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.	1,370	$340	$469.9K
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.	900	$450	$401.8K
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…	5,830	$40	$250.8K
99218	N/A	250	$780	$197.6K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	2,820	$70	$191.6K
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.	1,040	$160	$170.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	6,800	$20	$136K
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.	3,240	$40	$113.3K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	480	$200	$96.8K

Showing 1–10 of 130

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

South County Hospital Healthcare System — 2 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

130 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…	13	30	260	$60	$3.4M
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…	9	20	840	$210	$789.2K
99218	N/A	3	10	780	$720	$714.3K
J2405	Injection, ondansetron hydrochloride, per 1 mg	10	20	1,080	$180	$470.2K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	10	20	310	$210	$394.7K
J0690	Injection, cefazolin sodium, 500 mg	4	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.	10	20	280	$150	$330.2K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	10	20	1,500	$110	$327.5K
J3010	Injection, fentanyl citrate, 0.1 mg	7	10	490	$260	$310.4K
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.	46	280	290	$260	$296.3K

Showing 1–10 of 130

Nearby Providers

Other providers in the same ZIP code as South County Hospital Healthcare System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Prosseda	RI	General Practice Dentistry	$0	$5.2M
Joey Napolitano	RI	Public Health Dentistry	$0	$1.7M
Elise Jarvis	RI	Mental Health Counselor	$0	$1.7M
Rhode Island Pet Services, LLC	RI	Mobile Radiology Clinic/Center	$773.2K	$497.1K
Catherine Degood	RI	Addiction Medicine (Family Medicine) Physician	$3.1K	$1.1M
Emergency Physician Associates Of New England PC	RI	Emergency Medicine Physician	$0	$1M
Ira Kulman	RI	Clinical Neuropsychologist	$0	$1M
South Kingstown School Department	RI	Local Education Agency (LEA)	$0	$814K
Emily Colyer	RI	Emergency Medicine Physician	$36K	$528.6K
Town Of South Kingstown	RI	Land Ambulance	$338.7K	$217.5K

South County Hospital Healthcare System — Billing Profile & Reimbursement Data

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South County Hospital Healthcare System — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References