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.

Optum Urgent Care, PLLC (NPI 1285975797)

Optum Urgent Care, PLLC is a urgent care clinic/center provider located in Jericho, New York. This profile covers 0 Medicare and 33 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	Optum Urgent Care, PLLC
Address	555 N Broadway
City	Jericho
State	NY
ZIP	11753
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	March 7, 2013

Payer Source	Total Paid
Medicaid	$24.8M
Medicare	$0

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

33 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…	85,010	$120	$10.3M
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…	27,210	$150	$3.9M
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…	31,580	$120	$3.8M
S9083	Global fee urgent care centers	12,610	$240	$3M
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,…	11,130	$90	$990.9K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	23,130	$40	$879K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	29,660	$30	$771.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	4,440	$100	$425.9K
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…	2,980	$120	$363.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	11,330	$10	$90.7K

Showing 1–10 of 33

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

Optum Urgent Care, PLLC — 9 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

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	30	200	340	$120	$1.7M
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…	145	19,110	360	$70	$321K
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…	180	16,550	220	$90	$186.8K
99201	Deleted code, effective Jan. 1, 2021	180	190	90	$70	$167.3K
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,…	203	5,420	210	$70	$154.3K
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…	25	4,700	130	$100	$136.6K
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…	628	2,050	90	$140	$121.2K
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.	866	1,660	160	$20	$106.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	61	1,260	110	$80	$100.2K
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…	159	3,820	100	$130	$99.7K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Harold Augenstein	NY	Diagnostic Radiology Physician	$474.7K	$2.6K
Himanshu Patel	IL	Diagnostic Radiology Physician	$313.7K	$320
Jay Hammel	NY	Diagnostic Radiology Physician	$228.8K	$210
Patricia Roche	NY	Diagnostic Radiology Physician	$133.1K	$5K
Dimitri Ghecas	CT	Physician Assistant	$109K	$0
Rachel Shadrouz	NY	Medical Physician Assistant	$81.4K	$0
Richard Goldstein	NY	Emergency Medicine Physician	$72.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialty Portable X-ray, Inc	NY	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$2.2M	$200.2K
Michelle Yao	NY	Ophthalmology Physician	$395.8K	$175K
Specialty Portable X-ray Inc	NY	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$545.8K	$0
Tadeusz Strzelecki	NY	Anatomic Pathology & Clinical Pathology Physician	$196.7K	$17.9K
Sakshi Bajaj	NY	Neurology Physician	$161.3K	$2.4K
Amit Shelat	NY	Neurology Physician	$104.7K	$0
Lesley Rechter	NY	Family Medicine Physician	$40.5K	$0

Optum Urgent Care, PLLC — Billing Profile & Reimbursement Data

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Optum Urgent Care, PLLC — 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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