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 Amboys Pediatrics PA (NPI 1154711141)

The Amboys Pediatrics PA is a legal medicine provider located in Perth Amboy, New Jersey. This profile covers 0 Medicare and 105 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	The Amboys Pediatrics PA
Address	285 Mcclellan St
City	Perth Amboy
State	NJ
ZIP	08861
Taxonomy	Legal Medicine
NPI Enumerated	January 28, 2015

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

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

105 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…	44,080	$60	$2.7M
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…	16,220	$90	$1.4M
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,…	25,390	$40	$939.3K
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…	7,500	$80	$614.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	7,140	$80	$585.7K
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…	5,500	$80	$417.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,230	$90	$368.2K
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.	16,890	$20	$354.7K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	18,650	$10	$167.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	5,610	$30	$157.2K

Showing 1–10 of 105

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 Amboys Pediatrics PA — 11 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

105 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	29	50	670	$70	$280K
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…	90	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…	132	3,790	580	$60	$204K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	124	160	140	$170	$108.4K
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…	24	550	500	$60	$105.5K
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…	617	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…	30	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.	22	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.	32	680	900	$20	$82.5K
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,…	18	1,520	260	$40	$71.9K

Showing 1–10 of 105

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Passaic Pediatrics Ii PA	NJ	Pediatrics Physician	$0	$19.9M
Passaic Pediatrics PA	NJ	Pediatrics Physician	$0	$17.6M
Linda Santoro	NY	Family Nurse Practitioner	$34.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hmh Hospitals Corporation	NJ	General Acute Care Hospital	$0	$65.4M
Caliberhealth Plus	NJ	Home Health Agency	$0	$20.5M
2nd Home Perth Amboy Operations, LLC	NJ	Adult Day Care Clinic/Center	$0	$16.7M
Perth Amboy Public Schools	NJ	Local Education Agency (LEA)	$0	$16.5M
Graceland Adult Medical Day Care,inc	NJ	Adult Day Care Clinic/Center	$0	$16.1M
Bayada Home Health Care, Inc.	NJ	Home Health Agency	$0	$11.7M
Central Jersey Medical Center, Inc.	NJ	Federally Qualified Health Center (FQHC)	$0	$11.4M
County Of Middlesex	NJ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.5M
Raritan Bay Medical Center	NJ	General Acute Care Hospital	$0	$8.4M
Accredited Health Services	NJ	Home Health Agency	$0	$7.9M

The Amboys Pediatrics PA — Billing Profile & Reimbursement Data

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The Amboys Pediatrics PA — 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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