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.

Totowa Pediatric Group, P.A. (NPI 1366456105)

Totowa Pediatric Group, P.A. is a pediatrics physician provider located in Totowa, New Jersey. This profile covers 0 Medicare and 64 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	Totowa Pediatric Group, P.A.
Address	290 Union Blvd
City	Totowa
State	NJ
ZIP	07512
Taxonomy	Pediatrics Physician
NPI Enumerated	July 28, 2006

Payer Source	Total Paid
Medicaid	$8.1M
Medicare	$0

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

64 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…	48,940	$60	$3.1M
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…	9,950	$90	$924.9K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,820	$90	$719.6K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	9,130	$80	$712K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,330	$100	$600.9K
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.	28,830	$20	$518.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	4,000	$100	$407.8K
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,…	8,760	$40	$367.9K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	11,290	$20	$169.3K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	12,810	$10	$140.9K

Showing 1–10 of 64

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

Totowa Pediatric Group, P.A. — 10 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

64 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	77	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…	239	3,790	580	$60	$204K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	22	550	500	$60	$105.5K
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…	1,330	1,460	150	$80	$97.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	16	450	470	$60	$97K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	26	590	410	$60	$88.3K
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.	12	680	900	$20	$82.5K
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,…	51	1,520	260	$40	$71.9K
83655	The lab analyst performs a test to measure the amount of lead in the patient specimen. A typical aim of the test is to check for lead exposure.	97	170	170	$10	$71K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	28	530	310	$70	$65.5K

Showing 1–10 of 64

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
2nd Home Totowa LLC	NJ	Adult Day Care Clinic/Center	$0	$20.2M
Nextron Medical Technologies Inc.	NJ	Home Infusion Therapy Pharmacy	$0	$15.4M
Vito Modugno	NJ	Oral and Maxillofacial Surgery (Dentist)	$0	$9.2M
Safeway Medical Tranportation LLC	NJ	Land Ambulance	$2.7M	$161.3K
Jon Heller	NJ	Podiatrist	$258.5K	$974.3K
Marzena Odorczuk	NJ	Internal Medicine Physician	$213.1K	$0
Shaan Kataria	NJ	Radiation Oncology Physician	$166.6K	$0
Sean Santagato	NJ	Physical Therapist	$162.7K	$0
Eugene Batelli	NJ	Foot & Ankle Surgery Podiatrist	$161K	$0
Michael Klele	NJ	Family Medicine Physician	$115K	$0

Totowa Pediatric Group, P.A. — Billing Profile & Reimbursement Data

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Totowa Pediatric Group, P.A. — 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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