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.

Bronxcare Health System (NPI 1417027558)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bronxcare Health System
Address	1650 Grand Concourse
City	Bronx
State	NY
ZIP	10457
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$348.5M
Medicare	$0

BRONXCARE HEALTH SYSTEM is effectively a Medicaid-focused hospital: there is no Medicare billing on file while total Medicaid revenue is $348.5M, indicating the provider operates as a single-payer (Medicaid) revenue center in the available data rather than a mixed Medicare/Medicaid provider. This concentration implies that analyses of utilization, case-mix, and payer negotiation should be centered on Medicaid workflows and reimbursement patterns.

Revenue concentration in Medicaid is highly concentrated: the top 3 Medicaid codes by revenue account for 47.8% of the provider’s total Medicaid revenue. That level of concentration means a small set of outpatient E/M and ED services (notably evaluation & management codes) drive nearly half the Medicaid receipts, with important implications for operational risk and reimbursement sensitivity if Medicaid policy or coding practices change.

Service-line profile from the top codes indicates a high-volume outpatient and emergency care footprint. The largest single code is 99213 ($64.8M, 25.2% of Medicaid revenue) followed by 99214 ($36.9M, 14.4%) and 99283 ($20.9M, 8.1%), showing the hospital generates substantial revenue from established office/outpatient visits and low-level ED visits; this mix is consistent with a major acute-care facility with extensive ambulatory and emergency department throughput.

Competitive standing in-state is dominant for many Medicaid codes: BRONXCARE ranks in the 99th–100th percentile or top positions for numerous high-volume codes (for example 99213 ranks #11 of 19110 providers at the 100th percentile, 99214 ranks #7 of 16554 at the 100th percentile, and 36415 ranks #5 of 5089 at the 100th percentile). These percentile and rank placements describe a provider that is an extreme outlier or major volume hub across multiple outpatient, ED, lab, and therapy service lines relative to New York peers.

Behavior in emergency and urgent care is notable: multiple ED E/M codes (99282, 99283, 99284, 99285, 99281) appear in the top revenue list with substantial claim volumes and revenues (for example 99283 $20.9M and 99284 $17.8M). These entries, many described as "extreme outlier" or "notably above typical state volume," indicate heavy reliance on ED throughput and suggest the ED is a critical operational and financial driver for the hospital.

The provider has a significant behavioral health and procedural services presence within Medicaid volume: psychiatric codes such as 90832 ($15.5M) and 90791 ($10.9M), along with long-acting injectable J2426 ($2.7M, ranked #1 of 26 providers), indicate substantial outpatient mental health treatment and medication administration activity. This mix points to integrated behavioral health capacity alongside general acute care.

High-volume ancillary services and therapy are also important contributors: laboratory and procedural codes like 36415 ($6.1M), 80053 ($5.3M), 97010 ($4.8M, rank #1 of 318), and 97110 ($4.0M) are present at scaled volumes and high state-percentile ranks. These findings suggest BRONXCARE runs large-scale diagnostic, physical therapy, and outpatient ancillary programs that support its ambulatory and ED encounters.

Tenure and market presence are longstanding: the NPI was enumerated on 2006-11-08 (~20 years ago), indicating roughly two decades of operations under the current NPI registration. Combined with the provider’s repeated top-percentile rankings across many codes, this tenure supports a view of an established regional institution with durable high Medicaid utilization patterns.

Medicaid: Complete Services Breakdown

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

682 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…	526,830	$120	$64.8M
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…	269,570	$140	$36.9M
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.	102,790	$200	$20.9M
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.	91,300	$200	$17.8M
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…	130,980	$120	$15.5M
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,…	134,030	$110	$14.6M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	14,200	$770	$10.9M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	43,600	$240	$10.3M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	38,950	$190	$7.5M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	357,170	$20	$6.1M

Showing 1–10 of 682

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

Bronxcare Health System — 22 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

682 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G2067	Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed…	41	90	5,000	$210	$4.5M
H0020	Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program)	47	120	61,480	$30	$4.4M
J2505	Injection, pegfilgrastim, 6 mg	11	10	490	$2,730	$1.5M
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…	24	340	1,090	$70	$1.4M
J1561	Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg	14	20	140	$2,120	$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.	6	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…	12	1,510	1,010	$110	$1.1M
S9485	Crisis intervention mental health services, per diem	6	30	270	$1,190	$1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16	180	3,200	$90	$1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	37	40	200	$1,280	$940.3K

Showing 1–10 of 682

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronxcare Health System	NY	Internal Medicine Physician	$0	$62.3M
Mahmood Kazmi	NY	Psychiatry Physician	$540.6K	$760.6K
Fanyi Kong	NY	Anatomic Pathology & Clinical Pathology Physician	$577.7K	$6.8K
Misbahuddin Khaja	NY	Pulmonary Disease Physician	$69.3K	$179.3K
Sindhaghatta Venkatram	NY	Pulmonary Disease Physician	$49.4K	$108K
Dmitry Lvovsky	NY	Pulmonary Disease Physician	$42.4K	$112K
Simeon Lauer	NY	Ophthalmology Physician	$103.2K	$26.7K
Alan Miller	RI	Physician Assistant	$83K	$0
Raja Flores	NY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$78.4K	$140
Brandon Johnson	WI	Diagnostic Radiology Physician	$71.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Barnabas Hospital	NY	General Acute Care Hospital	$149.3K	$163.4M
Puerto Rican Organization To Motivate Enlighten And Serve Addicts Inc	NY	Substance Use Disorder Rehabilitation Clinic/Center	$439.8K	$64.2M
Puerto Rican Organization To Motivate Enlighten And Serve Addicts Inc	NY	Methadone Clinic	$0	$38.1M
Puerto Rican Organization To Motivate Enlighten And Serve Addicts, Inc	NY	Substance Abuse Rehabilitation Facility	$201.9K	$36.3M
Sbh Physicians, PC	NY	Internal Medicine Physician	$0	$31.5M
Puerto Rican Organization To Motivate Enlighten And Serve Addicts, Inc	NY	Substance Use Disorder Rehabilitation Clinic/Center	$457.1K	$23.5M
Joshua Rubinstein	NY	Specialist	$438.6K	$71K
Harvey Stern	NY	Diagnostic Radiology Physician	$260.6K	$80.3K
Shahin Gharib	NY	Emergency Medicine Physician	$291.6K	$7.5K
Juan Acosta	NY	Emergency Medicine Physician	$201.4K	$16.3K

Bronxcare Health System — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References