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.

Paul Simon (NPI 1417908468)

Field	Value
Entity Type	Individual
Organization	Paul Simon
Address	99 Highway 37
City	Toms River
State	NJ
ZIP	08755
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicare	$67.7K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	750	$30	$23.4K
88173	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results.	160	$60	$9.3K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	110	$70	$7.7K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	190	$20	$4.3K
88112	Selective cellular enhancement for cytopathology, such as the method of using a liquid–based slide preparation, uses a liquid–based medium to collect samples and preserve cells which can aid in…	140	$20	$3.2K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	100	$30	$3K
88172	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate immediately after aspiration to determine whether a sample satisfactory for diagnosis…	90	$30	$2.7K
88360	The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the…	60	$30	$2K
86255	The lab analyst performs an immunoassay test to screen a patient’s blood, typically serum, for an antibody to a noninfectious agent using a fluorescent method. As a screening test, results show only…	130	$20	$1.9K
84165	The lab analyst performs the technical lab test to separate and quantitate components of serum protein in a process called serum protein electrophoresis, SPE, or SPEP. The electrophoretic…	100	$10	$1.4K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. New Jersey Distribution

Paul Simon — 1 of 24 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. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	140	290	720	$40	$71.8K
86334	28	60	60	$20	$33K
88313	154	180	110	$50	$31.2K
88312	152	170	90	$80	$26.4K
88342	187	260	170	$50	$18.2K
84165	30	80	80	$10	$17.9K
88341	154	220	300	$40	$15.9K
84166	22	30	40	$20	$14.8K
88112	43	130	90	$40	$13.1K
88307	75	190	100	$80	$8.5K

Showing 1–10 of 24

Related Providers

Other providers that share a Tax Identification Number (TIN) with Paul Simon, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Deborah Heart And Lung Center	NJ	General Acute Care Hospital	$0	$9.5M
Michael Mcginnis	CA	Anatomic Pathology & Clinical Pathology Physician	$4.2M	$0
Raul Rudelli	NJ	Clinical Pathology/Laboratory Medicine Physician	$1.8M	$2M
Karabi Sinha	NJ	Anatomic Pathology & Clinical Pathology Physician	$1.9M	$0
Noah Lindenberg	NJ	Hematology & Oncology Physician	$1.8M	$0
Yijun Guo	PA	Clinical Pathology/Laboratory Medicine Physician	$1.3M	$0
Edmund Karam	NJ	Clinical Cardiac Electrophysiology Physician	$1M	$0
Hieu Huynh	VA	Clinical Cardiac Electrophysiology Physician	$642.5K	$0
Petronela Iorga	MA	Anatomic Pathology & Clinical Pathology Physician	$633K	$0
Mona Sharaan	NJ	Cytopathology Physician	$587.8K	$10.9K

Paul Simon — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Frequently Asked Questions

References