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.

The New York And Presbyterian Hospital (NPI 1194832477)

Field	Value
Entity Type	Organization
Organization	The New York And Presbyterian Hospital
Address	622 W 168th St
City	New York
State	NY
ZIP	10032
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 24, 2006

Payer Source	Total Paid
Medicaid	$455.2M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operator: there is no Medicare billing on file (none (no Medicare billing on file)) while lifetime Medicaid revenue is reported at $455.2M. The absence of Medicare activity combined with a large Medicaid revenue base indicates the hospital’s reimbursement exposure and growth levers are concentrated in state Medicaid contracting and programs.

Revenue is highly concentrated in a few evaluation-and-management codes: the precomputed top 3 Medicaid codes by revenue account for 42.1% of this provider's total Medicaid revenue, led by 99213 ($65.2M, 22.8%), 99283 ($31.5M, 11.0%), and 99284 ($23.7M, 8.3%). This concentration signals that outpatient and emergency E/M visits constitute the single largest revenue driver for the hospital’s Medicaid business.

The code mix points to a high-volume emergency department and ambulatory practice footprint: large volumes of ED E/M codes (99283, 99284, 99285, 99282) alongside established-patient office visit codes (99212, 99213, 99214) suggest sustained throughput in both urgent and scheduled outpatient care. High claim counts for infusion and procedure administration codes such as 96361 (43.9K claims, $12.7M) and 96365 (31.2K claims, $4.1M) further indicate substantial infusion/infusion-support capacity co-located with ED and outpatient services.

Competitive standing within New York is dominant for many of the hospital’s top codes: examples include 99213 (ranks #20 of 19110 providers in-state, 100th percentile; extreme outlier), 99283 (ranks #2 of 1423, 100th percentile; extreme outlier), and 99284 (ranks #6 of 2210, 100th percentile; extreme outlier). These rank and percentile positions indicate the hospital is a major statewide contributor to Medicaid volume for core ED and ambulatory E/M services, far above typical provider volumes.

Specialty ambulatory and procedural services are also significant components of revenue: preventive medicine codes 99391 (33.9K claims, $6.2M) and 99392 (26.5K claims, $4.8M), ophthalmology code 92012 (44K claims, $5.4M), and imaging codes like 70450 and 76700 together show a broad outpatient service mix that extends beyond emergency care into primary preventive services and specialty clinics. High volumes of 87633 (63.5K claims, $4.4M) indicate extensive respiratory virus testing capacity as part of the lab footprint.

The provider runs a substantial infusion and oncology-related service line: high-cost drug claims such as J9271 (pembrolizumab, $9M) and J1745 (infliximab, $7.1M), along with J1561 (immune globulin, $5.2M; ranks #1 of 15 providers in-state), and chemotherapy administration code 96413 ($3.6M, ranks #4 of 196) point to active specialty drug administration and oncology/infusion programs. The combination of high-cost drug spend and large administration procedure volumes signals this hospital is a referral center for complex outpatient infusions.

Case management and coordinated-care revenue exist but are not the primary driver: G9005 coordinated care fees ($13.2M) sit at a mid/low state percentile (rank #27 of 37, 28th percentile, characterized as typical/unremarkable), while T1016 case management ($9.9M, rank #7 of 41, 85th percentile) shows meaningful but not leading activity. These data suggest the hospital participates in care coordination programs at scale but is not a statewide leader for risk‑adjusted coordinated-care fees.

The hospital has an established presence in the market, with its NPI enumerated on 2006-08-24 (~20 years ago), and the combination of long tenure plus concentrated, high-volume Medicaid billing patterns positions it as an entrenched Medicaid provider in New York. Given the large Medicaid revenue base ($455.2M) and repeated appearance at or near the top percentile on many codes, payer analysts should treat this entity as a key Medicaid system counterparty for state-level network adequacy and high-volume service lines.

Medicaid: Complete Services Breakdown

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

1005 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…	343,160	$190	$65.2M
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.	172,120	$180	$31.5M
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.	132,350	$180	$23.7M
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…	117,880	$180	$21.3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	91,520	$170	$15.1M
G9005	Coordinated care fee, risk adjusted maintenance	42,850	$310	$13.2M
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.	43,900	$290	$12.7M
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,…	65,590	$190	$12.5M
T1016	Case management, each 15 minutes	42,780	$230	$9.9M
J9271	Injection, pembrolizumab, 1 mg	1,120	$8,010	$9M

Showing 1–10 of 1005

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

The New York And Presbyterian Hospital — 19 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

1005 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9005	Coordinated care fee, risk adjusted maintenance	27	40	105,510	$300	$55.6M
J2350	Injection, ocrelizumab, 1 mg	5	10	210	$26,790	$10.9M
J9271	Injection, pembrolizumab, 1 mg	9	20	750	$8,890	$8.1M
T1016	Case management, each 15 minutes	7	40	3,630	$220	$3.7M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	20	730	$2,870	$3.5M
J9299	Injection, nivolumab, 1 mg	6	10	360	$6,430	$3M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	5	10	300	$4,540	$2.5M
J3380	Injection, vedolizumab, intravenous, 1 mg	13	20	120	$5,050	$1.9M
J1726	Injection, hydroxyprogesterone caproate, (makena), 10 mg	4	10	1,060	$810	$1.9M
J2505	Injection, pegfilgrastim, 6 mg	2	10	490	$2,730	$1.5M

Showing 1–10 of 1005

Related Providers

Other providers that share a Tax Identification Number (TIN) with The New York And Presbyterian Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The New York And Presbyterian Hospital	NY	General Acute Care Hospital	$276.3K	$207.4M
New York And Presbyterian Hospital	NY	General Acute Care Hospital	$0	$49.5M
The New York And Presbyterian Hospital	NY	General Acute Care Hospital	$0	$18.8M
Eyal Levit	NY	MOHS-Micrographic Surgery Physician	$1.3M	$0
Wayne Luo	NY	Dermatology Physician	$1.1M	$0
Gwen Abeles	NJ	Procedural Dermatology Physician	$1M	$0
Stephen Nychay	NJ	MOHS-Micrographic Surgery Physician	$956.4K	$0
Peter Okin	NY	Cardiovascular Disease Physician	$322.8K	$576.7K
Donald Liss	NJ	Physical Medicine & Rehabilitation Physician	$575.1K	$0
John Walczyk	NY	Dermatology Physician	$504K	$0

Nearby Providers

Other providers in the same ZIP code as The New York And Presbyterian Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trustees Of Columbia University In The City Of New York	NY	Surgery Physician	$0	$96.9M
Trustees Of Columbia University In The City Of New York	NY	Internal Medicine Physician	$0	$54.9M
Columbia University Health Care, Inc.	NY	Dental Clinic/Center	$0	$29M
Trustees Of Columbia University In The City Of New York	NY	Internal Medicine Physician	$0	$21.4M
Trustees Of Columbia University In The City Of New York	NY	Anatomic Pathology & Clinical Pathology Physician	$254.6K	$7.4M
William Schiff	NY	Ophthalmology Physician	$1.9M	$430
Dean Preddie	NY	Nephrology Physician	$795.6K	$649.2K
David Silvers	NY	Dermatopathology Physician	$1.3M	$0
Gaetano Barile	NY	Ophthalmology Physician	$1.2M	$0
Mikhail Doubrovin	NY	Nuclear Medicine Physician	$1M	$117.9K

The New York And Presbyterian Hospital — Billing Profile & Reimbursement Data

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The New York And Presbyterian Hospital — 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