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.

St Josephs Medical Group PC (NPI 1205425519)

St Josephs Medical Group PC is a internal medicine physician provider located in Paterson, New Jersey. This profile covers 0 Medicare and 161 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	St Josephs Medical Group PC
Address	703 Main St
City	Paterson
State	NJ
ZIP	07503
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 12, 2021

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

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

161 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	32,590	$60	$2.1M
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…	34,350	$50	$1.5M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	8,340	$100	$817.5K
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…	23,060	$30	$576.5K
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…	9,730	$60	$554.8K
99204	The provider sees a new 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 provider…	6,090	$70	$450.8K
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…	4,370	$90	$393.2K
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…	12,820	$30	$384.5K
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…	3,770	$60	$226.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	6,060	$40	$212.1K

Showing 1–10 of 161

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

St Josephs Medical Group PC — 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

161 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	171	260	4,240	$220	$4.1M
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.	185	320	580	$230	$4M
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…	537	720	1,690	$80	$629.2K
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.	191	280	360	$560	$567.5K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	20	70	210	$1,050	$539.3K
S9083	Global fee urgent care centers	46	90	780	$90	$481.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	25	30	290	$590	$379.3K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	114	160	780	$110	$358.9K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	33	90	980	$230	$347.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	20	30	150	$1,170	$313.7K

Showing 1–10 of 161

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Joseph's Healthcare, Inc.	NJ	Internal Medicine Physician	$0	$31.7M
Jumana Chatiwala	NJ	Internal Medicine Physician	$1.3M	$0
Nawar Al Obaidi	NJ	Internal Medicine Physician	$400.4K	$11K
Michael Esposito	NJ	Urology Physician	$376.9K	$0
Mutahar Ahmed	NJ	Urology Physician	$320.2K	$0
Gregory Lovallo	NJ	Urology Physician	$307.9K	$0
Thomas Christiano	NJ	Urology Physician	$277.9K	$0
Nader Mahmood	NJ	Pulmonary Disease Physician	$210.9K	$54.2K
Andranik Howhannesian	NJ	Urology Physician	$253.8K	$0
Mehandar Kumar	NJ	Internal Medicine Physician	$230.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs University Medical Center Inc.	NJ	General Acute Care Hospital	$0	$322.3M
St. Joseph's Emergency Physicians Inc	NJ	Emergency Medical Services (Emergency Medicine) Physician	$0	$24.2M
Fayrouz Pediatric LLC	NJ	Pediatrics Physician	$0	$13.3M
St. Josephs Hospital And Medical Center	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$13.2M
Simeon Dialysis LLC	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.9M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Ellsworth Wright	NJ	Emergency Medicine Physician	$247.3K	$0
Orestes Sanchez	NJ	Diagnostic Radiology Physician	$225.5K	$0
Edward Milman	NJ	Diagnostic Radiology Physician	$221.9K	$0
Prashant Parashurama	NJ	Diagnostic Radiology Physician	$131.9K	$0

St Josephs Medical Group PC — Billing Profile & Reimbursement Data

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St Josephs Medical Group PC — 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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