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.

Fpa Hospital Based (NPI 1427398676)

Fpa Hospital Based is a emergency medicine physician provider located in New York, New York. This profile covers 0 Medicare and 30 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	Fpa Hospital Based
Address	100th St And Madison Ave
City	New York
State	NY
ZIP	10029
Taxonomy	Emergency Medicine Physician
NPI Enumerated	February 26, 2013

Payer Source	Total Paid
Medicaid	$71M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	181,030	$160	$29.5M
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.	243,240	$120	$28M
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.	172,910	$70	$11.4M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	5,310	$200	$1.1M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	110,950	$10	$665.7K
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…	1,410	$60	$83K
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…	1,030	$80	$81.1K
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.	1,680	$40	$58.8K
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,…	1,620	$30	$55.1K
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…	660	$50	$30.9K

Showing 1–10 of 30

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

Fpa Hospital Based — 5 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	1	1,420	90	$130	$715.2K
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.	168	450	370	$170	$674.1K
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.	2	2,210	80	$130	$473K
99281	The provider sees a patient for the lowest level emergency department visit.	162	220	350	$170	$321.3K
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…	5,725	19,110	360	$70	$321K
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.	2	2,330	100	$140	$254.7K
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…	405	640	1,080	$60	$251.5K
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…	4,003	16,550	220	$90	$186.8K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	83	180	120	$90	$179K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	44	80	210	$320	$162.5K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Parcare Community Health Network Inc	NY	Multi-Specialty Clinic/Center	$0	$88.5M
Ron Rosen	NY	Nuclear Medicine Physician	$2.4M	$8.9K
Sherif Heiba	NY	Nuclear Medicine Physician	$1.7M	$18.5K
Wen Fan	NY	Anatomic Pathology & Clinical Pathology Physician	$1.1M	$0
Thomas Mannino	NY	Diagnostic Radiology Physician	$851.8K	$0
Nasrin Ghesani	NY	Nuclear Medicine Physician	$699.2K	$17.1K
Reema Goel	MD	Nuclear Medicine Physician	$479.2K	$0
Elina Zaretsky	NY	Diagnostic Radiology Physician	$477.4K	$0
Michael Benanti	IL	Diagnostic Radiology Physician	$469.7K	$460
Lewen Stempler	NY	Nuclear Medicine Physician	$429.5K	$9.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mount Sinai Hospital	NY	General Acute Care Hospital	$0	$278.8M
Helping U Homecare, Inc.	NY	Home Health Agency	$0	$143.8M
New York City Health And Hospitals Corporation	NY	General Acute Care Hospital	$0	$100.7M
Icahn School Of Medicine At Mount Sinai	NY	Cardiovascular Disease Physician	$0	$21.7M
Center For Comprehensive Health Practice Inc	NY	Multi-Specialty Clinic/Center	$125.5K	$11.9M
Carnegie Hill Endoscopy LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$177.4K
Windsor Ting	NY	Vascular Surgery Physician	$36.3K	$1.6M
Joseph Shams	NY	Vascular & Interventional Radiology Physician	$1.5M	$142.3K
Su Jung Lee	NY	Family Nurse Practitioner	$931.2K	$0
Ignatius Lau	NY	Vascular Surgery Physician	$853.5K	$0

Fpa Hospital Based — Billing Profile & Reimbursement Data

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Fpa Hospital Based — 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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