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.

Department Of Health And Senior Services (NPI 1326168840)

Field	Value
Entity Type	Organization
Organization	Department Of Health And Senior Services
Address	50 E State St
City	Trenton
State	NJ
ZIP	08608
Taxonomy	Specialist
NPI Enumerated	March 29, 2007

Payer Source	Total Paid
Medicaid	$1.1B
Medicare	$0

Key Findings

This entity reports no Medicare billing on file and is effectively a single-payer Medicaid operation on file with this dataset; total Medicaid revenue is $1.07B, and there is no recorded Medicare revenue to compare against. The absence of Medicare activity means analyses of senior-care fee-for-service patterns or Medicare-driven lines of business are not applicable for this provider.

Revenue is highly concentrated in a very small set of Medicaid codes: the top three Medicaid codes account for 100.0% of Medicaid revenue, with T1018 alone representing $936.8M (87.4% of the provider's Medicaid revenue). This concentration indicates the provider's financials are overwhelmingly dependent on a single service line tied to T1018.

T1018 (School-based individualized education program (iep) services, bundled) dominates the profile with 3.1M claims at an average paid/claim of $299, producing $936.8M in revenue. The scale and code description signal that the provider operates large-scale school-based IEP services or a statewide bundled IEP program as its primary Medicaid business line.

99361 (no description available) is the second-largest Medicaid revenue source with 85.8K claims, $1010 avg paid/claim, and $86.7M revenue (8.1% of Medicaid revenue). Although the dataset does not provide a description for 99361, the high average paid/claim and its rank indicate it is a material, higher-dollar service line distinct from the school-based IEP billing.

T2023 (Targeted case management; per month) contributes $48.8M (4.5% of Medicaid revenue) from 93.3K claims at $523 avg paid/claim and ranks #2 of 16 providers in-state (93th percentile). Its presence shows an ongoing monthly case-management billing stream, but its statewide rank and the dataset label indicate this volume is typical and not exceptional relative to peers.

Competitive standing within New Jersey is dominant for the two largest codes: T1018 ranks #1 of 351 providers in-state and 99361 ranks #1 of 269 providers in-state, both flagged as 100th percentile extreme outliers. These rankings characterize the provider as a major, outlier-scale operator in the state for those specific services rather than a modest participant.

Operational tenure is long: the NPI was enumerated on 2007-03-29 (~19 years ago), indicating an established presence in the state Medicaid market and continuity across the observed high-volume service lines. This tenure supports the interpretation that the concentrated billing mix is a sustained business model rather than a short-term spike.

From a payer/provider analyst perspective, the profile signals concentration risk and strategic clarity: the organization is heavily specialized in school-based IEP services (T1018) supplemented by a substantial, high-dollar secondary code (99361) and recurring case-management (T2023). Any contract negotiations, audit focus, or capacity planning should prioritize the dominant T1018 service stream and the sizable but less well-defined 99361 activity, given these three codes together account for the provider's full Medicaid revenue base.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1018	School-based individualized education program (iep) services, bundled	3,133,220	$300	$936.8M
99361	N/A	85,850	$1,010	$86.7M
T2023	Targeted case management; per month	93,270	$520	$48.8M

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

Department Of Health And Senior Services — 2 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	2	20	65,220	$870	$62.3M
T1018	School-based individualized education program (iep) services, bundled	1	350	13,100	$120	$4.6M
99361	N/A	1	270	380	$1,610	$2.3M

Nearby Providers

Other providers in the same ZIP code as Department Of Health And Senior Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oaks Integrated Care, Inc	NJ	Community/Behavioral Health Agency	$0	$23.1M
Oaks Integrated Care, Inc	NJ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9M
Anjaneya Drugs LLC	NJ	Pharmacy	$15K	$0

Department Of Health And Senior Services — Billing Profile & Reimbursement Data

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Department Of Health And Senior Services — 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