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.

Mm Jc Breathing Center Family Ltd Partnership (NPI 1235365354)

Mm Jc Breathing Center Family Ltd Partnership is a internal medicine physician provider located in Jersey City, New Jersey. This profile covers 0 Medicare and 73 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	Mm Jc Breathing Center Family Ltd Partnership
Address	192 Harrison Avenue
City	Jersey City
State	NJ
ZIP	07304
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 3, 2009

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

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

73 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…	144,840	$30	$4.9M
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,…	36,730	$30	$918.3K
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…	19,980	$30	$679.3K
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…	5,480	$60	$306.8K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	4,770	$40	$205.2K
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…	5,200	$30	$155.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,270	$90	$113.9K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	2,270	$50	$113.3K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	21,240	$1	$85K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	4,050	$20	$76.9K

Showing 1–10 of 73

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

Mm Jc Breathing Center Family Ltd Partnership — 8 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

73 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	118	330	650	$200	$465.1K
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…	13	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…	100	3,790	580	$60	$204K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	697	730	1,350	$20	$155.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	120	280	1,260	$20	$127.3K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	148	240	430	$80	$111.2K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	34	60	190	$210	$110.6K
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…	807	1,020	550	$30	$105.3K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	135	230	300	$90	$103.3K
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…	69	1,460	150	$80	$97.8K

Showing 1–10 of 73

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hudson Milestones, Inc.	NJ	Developmentally Disabled Services Day Training Agency	$0	$50.3M
Spectrum Health Care, Inc.	NJ	Methadone Clinic	$444.5K	$16.8M
Care With Love	NJ	Adult Day Care Clinic/Center	$0	$16.7M
Catholic Charities - Mobile Response	NJ	Community/Behavioral Health Agency	$0	$16.6M
Khaleidoscope Health Care Inc.	NJ	Primary Care Clinic/Center	$0	$11.2M
Metropolitan Family Health Network, Inc.	NJ	Federally Qualified Health Center (FQHC)	$0	$8.4M
Fresenius Medical Care Jersey City, LLC	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8M
Ronald Sultan	NJ	Surgery Physician	$77.7K	$360.4K
Michelle Reisner	NJ	Internal Medicine Physician	$244.6K	$0
Elliot Shulman	NJ	Urology Physician	$193.7K	$0

Mm Jc Breathing Center Family Ltd Partnership — Billing Profile & Reimbursement Data

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Mm Jc Breathing Center Family Ltd Partnership — 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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