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.

Prohealth Care Associates LLP (NPI 1275596280)

Prohealth Care Associates LLP is a internal medicine physician provider located in Lake Success, New York. This profile covers 0 Medicare and 291 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	Prohealth Care Associates LLP
Address	2800 Marcus Ave
City	Lake Success
State	NY
ZIP	11042
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 10, 2006

Payer Source	Total Paid
Medicaid	$69.4M
Medicare	$0

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

291 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…	166,250	$90	$15M
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…	58,390	$130	$7.5M
S9083	Global fee urgent care centers	34,110	$180	$6M
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	24,920	$100	$2.5M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	20,230	$110	$2.3M
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…	20,600	$110	$2.2M
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…	60,570	$40	$2.1M
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	49,520	$40	$1.9M
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…	15,360	$110	$1.7M
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.	61,540	$20	$1.4M

Showing 1–10 of 291

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

Prohealth Care Associates LLP — 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

291 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	15	200	340	$120	$1.7M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	84	340	1,090	$70	$1.4M
90832	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…	1,099	1,510	1,010	$110	$1.1M
U0005	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…	95	300	1,710	$20	$458.6K
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.	508	610	310	$380	$397.9K
J0585	Injection, onabotulinumtoxina, 1 unit	71	80	150	$620	$380.1K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	27	200	470	$150	$336.9K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	61	260	300	$170	$325.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	11	490	840	$90	$323.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	40	2,060	1,300	$60	$322.2K

Showing 1–10 of 291

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Changping Jia	NY	Nuclear Imaging & Therapy Physician	$2.2M	$58.7K
Esther Lipstein-kresch	NY	Rheumatology Physician	$968.3K	$0
Anthony Wong	NY	MOHS-Micrographic Surgery Physician	$899.4K	$0
Scott Sheren	NY	Ophthalmology Physician	$818.5K	$0
Steven Goldberg	NY	Cardiovascular Disease Physician	$701.6K	$0
Daniel Hamou	NY	Ophthalmology Physician	$676.2K	$820
Scott Mandel	NY	Internal Medicine Physician	$642.9K	$0
Betty Motroni	NY	Diagnostic Radiology Physician	$466.1K	$13.8K
Adam Landskowsky	NY	Diagnostic Radiology Physician	$425.2K	$53.5K
Benjamin Abiri	NY	Diagnostic Radiology Physician	$442.8K	$4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Freedom Care LLC	NY	Home Health Agency	$0	$3B
Northwell Health Laboratories	NY	Clinical Medical Laboratory	$48.5M	$198.2M
Optum Medical Care Of New Jersey PC	NY	Pediatrics Physician	$0	$219.4M
North Shore University Hospital	NY	Case Management Agency	$0	$166.6M
Personal Touch Home Care Of New York, Inc.	NY	Early Intervention Provider Agency	$0	$19.3M
Nhpe, LLC	NY	Ambulatory Surgical Clinic/Center	$831.7K	$3M
Stuart Weinerman	NY	Endocrinology, Diabetes & Metabolism Physician	$2.3M	$2.3K
Jason Karp	NY	Pulmonary Disease Physician	$2.1M	$35.2K
Vishesh Agrawal	NY	Radiation Oncology Physician	$2.1M	$13K
Richard Furie	NY	Rheumatology Physician	$2.1M	$19.5K

Prohealth Care Associates LLP — Billing Profile & Reimbursement Data

Sign up for Prohealth Care Associates LLP — Billing Profile & Reimbursement Data policy alerts

Prohealth Care Associates LLP — Billing Profile & Reimbursement Data

Sign up for Prohealth Care Associates LLP — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References