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.

John T. Mather Memorial Hospital (NPI 1093718728)

John T. Mather Memorial Hospital is a general acute care hospital provider located in Port Jefferson, New York. This profile covers 0 Medicare and 166 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	John T. Mather Memorial Hospital
Address	75 N Country Rd
City	Port Jefferson
State	NY
ZIP	11777
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 27, 2005

Payer Source	Total Paid
Medicaid	$20.3M
Medicare	$0

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

166 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	15,270	$180	$2.7M
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.	15,400	$160	$2.5M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	7,760	$180	$1.4M
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.	7,840	$180	$1.4M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	11,060	$100	$1.1M
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.	1,020	$870	$886.2K
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…	9,190	$90	$864.1K
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…	6,250	$130	$787K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,310	$280	$645K
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.	2,080	$290	$599K

Showing 1–10 of 166

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

John T. Mather Memorial Hospital — 2 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

166 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	82	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.	166	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…	335	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…	219	2,200	1,010	$130	$892.2K
H0035	Mental health partial hospitalization, treatment, less than 24 hours	5	30	2,060	$220	$867.8K
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.	208	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.	143	450	370	$170	$674.1K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	68	140	360	$130	$492.1K
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.	140	2,210	80	$130	$473K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	20	110	690	$50	$442K

Showing 1–10 of 166

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Long Island Digestive Endoscopy Center, LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$1.4M
Nauman Piracha	CT	Hospitalist Physician	$489.5K	$104.3K
Jason Kreiner	NY	Pain Medicine (Anesthesiology) Physician	$318.6K	$11.1K
Gregg Zimmerman	NJ	Urology Physician	$293K	$0
Michael Parrott	NY	Emergency Medicine Physician	$180.8K	$54.8K
Eddie Kim	NV	Emergency Medicine Physician	$172K	$44.5K
Erica Katz	OH	Emergency Medicine Physician	$149.3K	$65.3K
Philip Claire	FL	Vascular & Interventional Radiology Physician	$205K	$0
Elham Safaie	NY	Nuclear Medicine Physician	$195K	$0
Kevin Hinphy	NY	Certified Registered Nurse Anesthetist	$192.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahmad Bhatti	NY	Vascular Surgery Physician	$1.3M	$0
Brian Durkin	NY	Pain Medicine (Anesthesiology) Physician	$797.8K	$8.9K
Anzhelika Vaccaro	NY	Ophthalmology Physician	$605.1K	$102K
Brian Mcginley	NY	Orthopaedic Surgery Physician	$499.4K	$0
Nick Patel	NY	Pulmonary Disease Physician	$355.3K	$0
George Fairey	NY	Psychiatry Physician	$347.5K	$0
Michael Fracchia	NY	Orthopaedic Surgery Physician	$321.8K	$100
Matthew Boylan	NY	Sports Medicine (Orthopaedic Surgery) Physician	$210.3K	$0
Jessica Blydenburgh	NY	Family Medicine Physician	$183.2K	$2K
Mindy Shaffran	NY	Obstetrics & Gynecology Physician	$178.5K	$0

John T. Mather Memorial Hospital — Billing Profile & Reimbursement Data

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John T. Mather Memorial Hospital — 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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