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.

Restorative Management Corp (NPI 1043385578)

Field	Value
Entity Type	Organization
Organization	Restorative Management Corp
Address	7 Railroad Ave
City	Middletown
State	NY
ZIP	10940
Taxonomy	Substance Abuse Rehabilitation Facility
NPI Enumerated	November 21, 2006

Payer Source	Total Paid
Medicaid	$18.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	63,710	$110	$7.3M
H0005	Alcohol and/or drug services; group counseling by a clinician	119,040	$60	$7M
S9480	Intensive outpatient psychiatric services, per diem	8,280	$110	$918.6K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	4,720	$190	$900.8K
H0038	Self‑help/peer services, per 15 minutes	17,180	$50	$773.2K
H0004	Behavioral health counseling and therapy, per 15 minutes	13,270	$50	$676.7K
G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	2,890	$150	$439.7K
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…	2,010	$150	$294.7K
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…	1,480	$150	$219.9K
99204	The provider sees a new 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 provider…	30	$140	$4.7K

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

Restorative Management Corp — 4 of 10 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0005	Alcohol and/or drug services; group counseling by a clinician	3	230	3,600	$60	$805.5K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	6	250	1,290	$110	$761.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	34	270	1,340	$110	$658.2K
G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	61	190	1,030	$140	$613.3K
S9480	Intensive outpatient psychiatric services, per diem	7	50	860	$110	$364.8K
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…	5,581	19,110	360	$70	$321K
H0038	Self‑help/peer services, per 15 minutes	7	240	950	$70	$205.4K
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…	2,437	16,550	220	$90	$186.8K
99204	The provider sees a new 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 provider…	2,642	3,820	100	$130	$99.7K
H0002	Behavioral health screening to determine eligibility for admission to treatment program	3	200	140	$110	$65.4K

Nearby Providers

Other providers in the same ZIP code as Restorative Management Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Middletown Medical PC	NY	Emergency Medicine Physician	$0	$49.3M
Garnet Health Medical Center	NY	General Acute Care Hospital	$0	$45.1M
Joseph Racanelli	NY	Diagnostic Radiology Physician	$945.7K	$478.9K
Bonnie Seecharran	NY	Cardiovascular Disease Physician	$663K	$15.3K
Vivek Patil	NY	Vascular & Interventional Radiology Physician	$654.1K	$2.3K
David Lowenkron	NY	Specialist	$594.2K	$21.3K
Thomas Eanelli	NY	Radiation Oncology Physician	$568.2K	$390
Quazi Al-tariq	NY	Psychiatry Physician	$90.5K	$477.7K
Jagruti Gohel	NY	Family Medicine Physician	$408.6K	$119.9K
Elina Zaretsky	NY	Diagnostic Radiology Physician	$477.4K	$0

Restorative Management Corp — Billing Profile & Reimbursement Data

Sign up for Restorative Management Corp — Billing Profile & Reimbursement Data policy alerts

Restorative Management Corp — Billing Profile & Reimbursement Data

Sign up for Restorative Management Corp — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References