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.

The Promptcare Companies, Inc. (NPI 1083615991)

Field	Value
Entity Type	Organization
Organization	The Promptcare Companies, Inc.
Address	41 Spring St Ste 103a
City	New Providence
State	NJ
ZIP	07974
Taxonomy	Oxygen Equipment & Supplies (DME)
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$83.1M
Medicare	$0

Key Findings

THE PROMPTCARE COMPANIES, INC. is effectively a single-payer Medicaid supplier at scale: there is no Medicare billing on file and the provider reports $83.1M in total Medicaid revenue. This payer concentration means analyses and network negotiations should be evaluated primarily through the Medicaid lens rather than Medicare performance or exposure.

Revenue is highly concentrated in a small set of Medicaid DME codes: the precomputed top 3 Medicaid codes by revenue account for 56.7% of this provider's total Medicaid revenue, led by E0465 ($19.6M, 25.2%), E0466 ($17.1M, 22.0%) and B4035 ($7.5M, 9.6%). That concentration signals that a majority of Medicaid dollars flow through ventilator care and enteral feeding supply lines.

The code mix indicates an operational focus on complex respiratory support and enteral nutrition: E0465 (Home ventilator, invasive interface) and E0466 (Home ventilator, non-invasive interface) are the top revenue drivers, and B4035 (Enteral feeding supply kit; pump fed, per day) is the third-largest contributor. This combination suggests the business is structured to supply long-term home ventilator management and daily enteral supplies rather than one-off DME transactions.

THE PROMPTCARE is a dominant statewide supplier for multiple ventilator and respiratory codes: E0465 ranks #1 of 7 providers in-state (100th percentile; notably above typical state volume) and E0466 ranks #1 of 14 providers in-state (100th percentile; extreme outlier, far above typical state volume). Those rank positions and percentile labels indicate market leadership in both invasive and non-invasive home ventilation within New Jersey.

The provider is also a major player in enteral nutrition and related supplies: B4035 is $7.5M (9.6%) and ranks #2 of 19 providers in-state (94th percentile), while pediatric and specialty enteral formulas such as B4161 ($5.6M, 7.2%) and B4160 ($2.0M, 2.5%) respectively rank #1 in-state (100th percentile). This pattern shows the firm competes strongly across both consumable enteral supplies and higher-cost specialty formulas.

THE PROMPTCARE posts extreme or notable outlier volumes across several auxiliary DME categories that support chronic respiratory care: E0445 (Oximeter) is flagged an extreme outlier with $2.2M (2.8%), and E0431 (Portable gaseous oxygen system, rental) is flagged an extreme outlier with $1M (1.3%). In addition, E1390 (Oxygen concentrator) contributes $5.2M (6.7%) and ranks #2 of 33 providers in-state (97th percentile), underscoring a broad, above-average footprint across oxygen therapy equipment.

Operationally, the provider combines very high claim volumes with low unit reimbursements on staple items and higher unit payments on specialty devices: examples include E1390 at 53.5K claims with $97 avg paid/claim, E0431 at 51.3K claims with $20 avg paid/claim, and B4035 at 36.8K claims with $203 avg paid/claim. This mix implies a logistics-intensive operation managing large recurring deliveries and rentals alongside higher-cost durable devices.

THE PROMPTCARE has a long-tenured NPI (enumerated 2005-08-02, ~21 years ago), which supports the pattern of an established, entrenched Medicaid supply operation in New Jersey rather than a recent market entrant. Longevity combined with frequent #1 statewide rankings suggests sustained market share in its core DME lines.

Medicaid: Complete Services Breakdown

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

94 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	23,600	$830	$19.6M
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	24,740	$690	$17.1M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	36,800	$200	$7.5M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	8,200	$690	$5.6M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	53,450	$100	$5.2M
A4624	Tracheal suction catheter, any type other than closed system, each	14,610	$200	$3M
E1399	Durable medical equipment, miscellaneous	25,460	$110	$2.9M
E0445	Oximeter device for measuring blood oxygen levels non-invasively	20,540	$110	$2.2M
B4160	Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…	8,360	$230	$2M
B9998	Noc for enteral supplies	9,850	$150	$1.5M

Showing 1–10 of 94

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

The Promptcare Companies, Inc. — 21 of 25 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. New Jersey median

94 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
E0465	Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)	1	10	2,120	$750	$3.4M
E0466	Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)	1	10	890	$510	$1.9M
B4161	Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…	1	10	1,400	$680	$1.4M
T4523	Adult sized disposable incontinence product, brief/diaper, large, each	15	20	1,230	$60	$1.2M
T4522	Adult sized disposable incontinence product, brief/diaper, medium, each	8	10	1,060	$40	$1.1M
B4035	Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape	2	20	1,080	$100	$750.7K
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	2	30	3,690	$60	$569.3K
A6209	Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing	1	10	4,400	$130	$567.8K
A4554	Disposable underpads, all sizes	14	40	1,080	$30	$564K
E0482	Cough stimulating device, alternating positive and negative airway pressure	1	10	1,980	$200	$532.5K

Showing 1–10 of 94

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Promptcare Companies, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Promptcare Companies, Inc.	PA	Oxygen Equipment & Supplies (DME)	$0	$78.5M
The Promptcare Companies, Inc.	TN	Oxygen Equipment & Supplies (DME)	$0	$3.3M
The Promptcare Companies, Inc.	CT	Durable Medical Equipment & Medical Supplies	$0	$1.8M

Nearby Providers

Other providers in the same ZIP code as The Promptcare Companies, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Our House, Inc.	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$99.6M
Promptcare Home Infusion, LLC	NJ	Home Infusion Therapy Pharmacy	$0	$14.2M
Bdx Solutions, Inc.	NJ	Physiological Laboratory	$9.3M	$363.4K
Irina Marcoff	NJ	Physical Therapist	$396.6K	$0
Sunita Borkar	NJ	Diagnostic Radiology Physician	$390.3K	$0
Terrence Lee	NJ	Diagnostic Radiology Physician	$382.3K	$0
Joshua Curran	NJ	Diagnostic Radiology Physician	$263.9K	$0
Sidney Glasofer	NJ	Cardiovascular Disease Physician	$226.9K	$0
David Bartov	NJ	Interventional Cardiology Physician	$160K	$0
Jared Preston	NJ	Adult Reconstructive Orthopaedic Surgery Physician	$137.4K	$0

The Promptcare Companies, Inc. — Billing Profile & Reimbursement Data

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The Promptcare Companies, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References