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.

New York Network Ipa Inc (NPI 1275665457)

Key Findings

Field	Value
Entity Type	Organization
Organization	New York Network Ipa Inc
Address	34 35th St Ste 4-b517
City	Brooklyn
State	NY
ZIP	11232
Taxonomy	Exclusive Provider Organization
NPI Enumerated	March 12, 2007

Payer Source	Total Paid
Medicaid	$529.1M
Medicare	$0

This entity is effectively a Medicaid-focused operator: it reports no Medicare billing on file and $529.1M in lifetime Medicaid revenue, so Medicaid drives its entire recorded public-payor footprint. The absence of Medicare claims means comparisons to national Medicare peers are not applicable for this profile.

Revenue is highly concentrated in a small set of services: the precomputed top 3 Medicaid codes together account for 41.9% of total Medicaid revenue, led by U0003 ($98.4M revenue, 23.0%), followed by 99213 ($45.9M, 10.7%) and 97530 ($35.6M, 8.3%). This concentration indicates that a minority of service lines produce a plurality of the provider’s Medicaid income.

The code mix identifies a high-volume outpatient and ambulatory services operation with strong diagnostic and therapy throughput: U0003, U0005 and 87635 signal large-scale SARS-CoV-2 testing activity; 99211–99214 codes reflect massive primary outpatient E/M volume; and 97530, 97110, 97112 and 97140 point to an extensive rehabilitation/physical-therapy program. Together these lines suggest the organization functions as a broad outpatient network offering testing, E/M visits, therapy, imaging, and behavioral health.

Competitive standing in-state is dominant for many codes: U0003 ranks #1 of 336 providers in-state (100th percentile; extreme outlier), 97530 ranks #2 of 2061 (100th percentile; extreme outlier), and multiple therapy and imaging codes (e.g., 97110, 99211, 97112, 97140, 76700) also rank at or near #1 and at the 100th percentile. These rankings indicate the provider is a major statewide player and an extreme outlier in volume for several service lines.

The claim volumes reported reinforce the scale of operations: examples include 1.4M claims for U0003, 1.4M claims for 99211, 670.6K claims for 97110, 552.6K claims for 99213, and 481.8K claims for 97112. Such high claim counts across testing, E/M, and therapy codes imply a large throughput model that relies on high encounter frequency.

Price-per-claim patterns show a mix of low-unit-value, high-volume services and higher-paid procedures: U0005 averages $24 paid/claim and 99211 averages $24 paid/claim, while higher-reimbursement services include 99214 at $116 avg paid/claim, 77067 at $129, and 90837 at $131. This suggests the provider combines low-margin mass services (e.g., testing, brief visits) with higher-revenue imaging and extended E/M or psychotherapy encounters.

Operational sensitivity is concentrated in COVID-related testing and high-volume outpatient codes: U0003 alone represents $98.4M (23.0%) of Medicaid revenue and is labeled an "extreme outlier," and related testing codes (U0005, 87635) also appear prominently. Because top codes account for 41.9% of Medicaid revenue, changes in testing demand, visit patterns, or reimbursement for those few codes could meaningfully affect overall Medicaid revenue.

Medicaid: Complete Services Breakdown

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

786 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,406,310	$70	$98.4M
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…	552,610	$80	$45.9M
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.	531,360	$70	$35.6M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,427,960	$20	$34.3M
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,…	1,403,920	$20	$33.7M
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…	670,550	$30	$20.1M
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…	161,940	$120	$18.8M
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…	122,330	$130	$15.8M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	113,780	$130	$14.9M
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…	481,750	$30	$13.5M

Showing 1–10 of 786

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

New York Network Ipa Inc — 25 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

786 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1	340	1,090	$70	$1.4M
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.	210	210	2,850	$180	$1.1M
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…	460	1,510	1,010	$110	$1.1M
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…	39	2,200	1,010	$130	$892.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	7	750	1,800	$80	$785.8K
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.	649	1,420	90	$130	$715.2K
36478	In this procedure, the provider inserts a specially designed laser ablation catheter probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code…	29	50	180	$1,040	$575K
36466	In this procedure, the provider injects a noncompounded foam sclerosing solution into multiple incompetent truncal veins under ultrasound guidance to guide the dispersion of foam, most commonly to…	3	20	80	$1,400	$532.2K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	81	140	360	$130	$492.1K
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.	350	2,210	80	$130	$473K

Showing 1–10 of 786

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Assistcarehome Healthcare Services	NY	Home Health Agency	$0	$1.4B
Platinum Home Health Care Inc.	NY	Home Health Agency	$0	$866M
Human Care LLC	NY	Home Health Agency	$0	$839.5M
Js Home Care Agency Of Ny	NY	Home Health Agency	$0	$389.1M
Ateres Mordechai	NY	Early Intervention Provider Agency	$0	$66.5M
Human Care LLC.	NY	Home Health Agency	$0	$59.9M
Unicare C.d.c.	NY	Home Health Agency	$0	$26.2M
Js Homecare Agency Of Ny, Inc.	NY	Home Health Agency	$0	$25M
Postgraduate Center For Mental Health	NY	Community/Behavioral Health Agency	$0	$23.6M
Enrique Guillen	NY	General Practice Dentistry	$265.5K	$0

New York Network Ipa Inc — Billing Profile & Reimbursement Data

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New York Network Ipa Inc — 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

Nearby Providers

Frequently Asked Questions

References