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

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

Scotch Plains Specialty Pharmacy LLC (NPI 1023662384)

Field	Value
Entity Type	Organization
Organization	Scotch Plains Specialty Pharmacy LLC
Address	242 Lincoln Blvd
City	Middlesex
State	NJ
ZIP	08846
Taxonomy	Pharmacy
NPI Enumerated	July 25, 2019

Payer Source	Total Paid
Medicare	$5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90694	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…	40	$80	$2.6K
G0008	Administration of influenza virus vaccine	40	$30	$1.2K
0134A	N/A	30	$40	$1.2K
91313	N/A	30	$0	$0

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Jersey Distribution

Scotch Plains Specialty Pharmacy LLC — 0 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90694	1,035	1,460	70	$70	$8.4K
G0008	2,720	4,290	50	$30	$3K
0134A	234	500	30	$40	$1.8K
91313	2	10	20	$0	$0

Nearby Providers

Other providers in the same ZIP code as Scotch Plains Specialty Pharmacy LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Precious Hands Healthcare LLC	NJ	Home Health Agency	$0	$22M

Scotch Plains Specialty Pharmacy LLC — Billing Profile & Reimbursement Data

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Scotch Plains Specialty Pharmacy LLC — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References