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.

Boro Park Pediatric Associates, PLLC (NPI 1063629186)

Boro Park Pediatric Associates, PLLC is a pediatrics physician provider located in Brooklyn, New York. This profile covers 0 Medicare and 63 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	Boro Park Pediatric Associates, PLLC
Address	4406 12th Ave
City	Brooklyn
State	NY
ZIP	11219
Taxonomy	Pediatrics Physician
NPI Enumerated	May 17, 2007

Payer Source	Total Paid
Medicaid	$31.2M
Medicare	$0

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

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	223,140	$80	$17.4M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22,280	$100	$2.3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	17,810	$100	$1.8M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	48,910	$30	$1.5M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	15,980	$90	$1.4M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,360	$100	$954.8K
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…	6,420	$130	$802K
87070	The lab analyst performs the technical lab steps to culture a specimen from any source except urine, blood, or stool. This service involves aerobic culture, which refers to the presence of oxygen.…	99,250	$10	$794K
87184	The lab analyst performs the technical steps to evaluate a culture isolate’s susceptibility, or sensitivity, to up to 12 specific antimicrobial agents, commonly called antibiotics, by placing disks…	99,450	$10	$696.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	14,800	$50	$681K

Showing 1–10 of 63

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

Boro Park Pediatric Associates, PLLC — 17 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

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	39	19,110	360	$70	$321K
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…	798	16,550	220	$90	$186.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	38	1,150	480	$70	$178K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	28	1,420	490	$70	$176.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	157	5,420	210	$70	$154.3K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	123	140	210	$290	$144.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	25	1,560	470	$70	$142.7K
99203	The provider sees a new 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 provider…	4,201	4,700	130	$100	$136.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,603	2,050	90	$140	$121.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,046	1,260	110	$80	$100.2K

Showing 1–10 of 63

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A & J Staffing, Inc	NY	Home Health Agency	$0	$776.3M
The Royal Care Inc	NY	Home Health Agency	$0	$738.8M
Community Home Care Referral Service, Inc.	NY	Home Health Agency	$0	$527.5M
The Royal Care Fi LLC	NY	Home Health Agency	$0	$323.7M
Hamaspik Of Kings County	NY	Case Management Agency	$0	$295.2M
Maimonides Medical Center	NY	General Acute Care Hospital	$0	$260.9M
All Care Home Health Services LLC	NY	Home Health Agency	$0	$260M
Alternate Staffing, Inc.	NY	Home Health Agency	$0	$236.5M
Human Care Services For Families And Children Inc	NY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$204M
Regency Health Care, Inc	NY	Home Health Agency	$0	$157.6M

Boro Park Pediatric Associates, PLLC — Billing Profile & Reimbursement Data

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Boro Park Pediatric Associates, 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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Frequently Asked Questions

References