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.

Cooper Pediatrics (NPI 1144268277)

Cooper Pediatrics is a pediatrics physician provider located in Camden, New Jersey. This profile covers 0 Medicare and 66 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	Cooper Pediatrics
Address	3 Cooper Plz
City	Camden
State	NJ
ZIP	08103
Taxonomy	Pediatrics Physician
NPI Enumerated	June 2, 2006

Payer Source	Total Paid
Medicaid	$31.9M
Medicare	$0

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

66 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	33,400	$170	$5.7M
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…	35,020	$150	$5.2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	25,700	$160	$4.1M
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…	85,330	$30	$2.5M
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.	82,880	$30	$2.4M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	14,040	$170	$2.3M
90697	This code represents a combination vaccine product administered into the muscle to protect against six diseases: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib), and…	7,060	$210	$1.5M
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	33,550	$40	$1.2M
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4,930	$230	$1.1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9,000	$120	$1.1M

Showing 1–10 of 66

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

Cooper Pediatrics — 19 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

66 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…	42	4,450	740	$40	$229.8K
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…	405	3,790	580	$60	$204K
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…	2	550	500	$60	$105.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	88	1,020	550	$30	$105.3K
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…	490	740	150	$100	$100.3K
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…	561	1,460	150	$80	$97.8K
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…	2	450	470	$60	$97K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2	590	410	$60	$88.3K
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.	2	680	900	$20	$82.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	382	660	330	$40	$82K

Showing 1–10 of 66

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Cooper Health System	NJ	General Acute Care Hospital	$0	$354M
Virtua Our Lady Of Lourdes Hospital Inc	NJ	General Acute Care Hospital	$0	$98.3M
Cmc Department Of Medicine Group PA	NJ	Specialist	$0	$77.4M
Cooper Univeristy Emergency Physicians, PC	NJ	Emergency Medicine Physician	$0	$55.5M
Cooper Surgical Associates, PA	NJ	Surgery Physician	$0	$34.7M
Cooper Physician Offices, PA	NJ	Internal Medicine Physician	$0	$33.7M
Cooper University Radiology, PC	NJ	Diagnostic Radiology Physician	$0	$22.9M
South Jersey Behavioral Health Resources, Inc.	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$21.8M
Camcare Health Corporation	NJ	Federally Qualified Health Center (FQHC)	$0	$15.9M
Haddon Emergency Physicians LLC	NJ	Emergency Medicine Physician	$0	$11.9M

Cooper Pediatrics — Billing Profile & Reimbursement Data

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Cooper Pediatrics — 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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