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

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

Upmc Chautauqua At Wca (NPI 1033227111)

Upmc Chautauqua At Wca is a hospitalist physician provider located in Jamestown, New York. This profile covers 0 Medicare and 372 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	Upmc Chautauqua At Wca
Address	207 Foote Ave
City	Jamestown
State	NY
ZIP	14701
Taxonomy	Hospitalist Physician
NPI Enumerated	August 28, 2006

Payer Source	Total Paid
Medicaid	$38.7M
Medicare	$0

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

372 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	24,370	$170	$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.	26,860	$140	$3.6M
90832	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…	24,960	$130	$3.2M
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…	26,620	$80	$2.2M
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…	9,790	$160	$1.6M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	46,090	$30	$1.5M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	4,300	$320	$1.4M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	6,800	$190	$1.3M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	2,060	$590	$1.2M
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.	8,880	$110	$985.6K

Showing 1–10 of 372

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

Upmc Chautauqua At Wca — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

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

372 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	80	340	1,090	$70	$1.4M
G0378	Hospital observation service, per hour	30	130	1,270	$560	$1.2M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	107	210	2,850	$180	$1.1M
90832	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…	117	1,510	1,010	$110	$1.1M
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…	315	2,200	1,010	$130	$892.2K
H0005	Alcohol and/or drug services; group counseling by a clinician	188	230	3,600	$60	$805.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	540	750	1,800	$80	$785.8K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	163	250	1,290	$110	$761.7K
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.	95	1,420	90	$130	$715.2K
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.	127	450	370	$170	$674.1K

Showing 1–10 of 372

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Amir Salem	NY	Vascular & Interventional Radiology Physician	$5M	$605.9K
Israr Abbasi	NY	Psychiatry Physician	$99K	$423.1K
Ellen Dailey	PA	Obstetrics & Gynecology Physician	$72.4K	$276.7K
James Cirbus	NY	Cardiovascular Disease Physician	$232.6K	$32.8K
George So	NY	Cardiovascular Disease Physician	$163.5K	$36.7K
Anthony Mangano	NY	Diagnostic Radiology Physician	$155.9K	$5K
Dana Jackson	MD	Diagnostic Radiology Physician	$118K	$0
John Lamancuso	NY	Internal Medicine Physician	$102.8K	$300
Evadne Ong	NY	Internal Medicine Physician	$100.4K	$0
Danko Vidovich	ND	Neuroradiology Physician	$12.9K	$20.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chautauqua County Dmh Health Homes	NY	Case Management Agency	$0	$25.8M
Wca Services Corporation	NY	Ambulance	$900.2K	$5.7M
Surjeet Pohar	NY	Radiation Oncology Physician	$745.5K	$0
Ryan White	NY	Urology Physician	$403.8K	$40.3K
Eric Arnone	NY	Urology Physician	$256.6K	$51.1K
Jairus Ibabao	NY	Hematology & Oncology Physician	$266.6K	$31.2K
Benjamin Luong	NY	Urology Physician	$245.6K	$24.2K
Tanvir Dara	NY	Internal Medicine Physician	$12.6K	$204.7K
Antonio Roman	NY	Cardiovascular Disease Physician	$178.2K	$30.9K
James Campion	NY	Gastroenterology Physician	$157K	$6.6K

Upmc Chautauqua At Wca — Billing Profile & Reimbursement Data

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Upmc Chautauqua At Wca — 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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