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.

Boston Children's Health Physicians, LLP (NPI 1467454967)

Boston Children's Health Physicians, LLP is a pediatrics physician provider located in Hawthorne, New York. This profile covers 0 Medicare and 194 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	Boston Children's Health Physicians, LLP
Address	19 Skyline Dr Ofc 1n-d06
City	Hawthorne
State	NY
ZIP	10532
Taxonomy	Pediatrics Physician
NPI Enumerated	August 15, 2005

Payer Source	Total Paid
Medicaid	$52.9M
Medicare	$0

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

194 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	127,050	$120	$14.6M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	58,160	$200	$11.5M
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…	79,270	$80	$6.5M
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.	69,810	$20	$1.7M
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	4,870	$270	$1.3M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2,610	$480	$1.3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	10,610	$100	$1.1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7,350	$140	$1M
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…	8,440	$110	$885.9K
99204	The provider sees a new 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 provider…	4,110	$200	$826.9K

Showing 1–10 of 194

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

Boston Children's Health Physicians, LLP — 15 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

194 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90834	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…	817	2,200	1,010	$130	$892.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	690	750	1,800	$80	$785.8K
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	8	10	1,530	$400	$755.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	501	610	310	$380	$397.9K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	5	40	90	$380	$367K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	76	200	470	$150	$336.9K
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…	164	19,110	360	$70	$321K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	12	150	230	$260	$312.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	295	430	680	$120	$299.9K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	3	10	50	$860	$273.3K

Showing 1–10 of 194

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Theresa Timony	CA	Psychiatric/Mental Health Nurse Practitioner	$875.5K	$0
Oscar Castillo	CA	Psychiatric/Mental Health Nurse Practitioner	$798.5K	$0
Sharanna Johnson	FL	Adult Health Nurse Practitioner	$124.9K	$0
Jaqueta Williams	CA	Family Nurse Practitioner	$107.8K	$0
Belinda Marquis	NY	Neurology with Special Qualifications in Child Neurology Physician	$100.7K	$2.8K
Steven Wolf	NY	Neurology Physician	$79.3K	$23.2K
Donna Brunson	NV	Psychiatric/Mental Health Nurse Practitioner	$79.4K	$0
Catherine Donnerstag	MD	Psychiatric/Mental Health Nurse Practitioner	$70.9K	$0
Shireen Pais	NY	Gastroenterology Physician	$58K	$0
Amanda Jayaraman	CO	Psychiatric/Mental Health Nurse Practitioner	$48.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New Vision Home Care Services, LLC	NY	Home Health Agency	$0	$18.8M
Peter Coombs	NY	Retina Specialist (Ophthalmology) Physician	$1.4M	$0
Anthony Gilet	NY	Diagnostic Radiology Physician	$1.2M	$63.7K
Albert Deluca	NY	Cardiovascular Disease Physician	$788.3K	$3K
Jean Tostanoski	NY	Ophthalmology Physician	$443.6K	$860
Carmine Sorbera	NY	Clinical Cardiac Electrophysiology Physician	$291.7K	$0
Edmund Farris	NY	Ophthalmology Physician	$267.6K	$50
Karen Seiter	NY	Hematology & Oncology Physician	$180.1K	$41.2K
Delong Liu	NY	Hematology & Oncology Physician	$134.9K	$9.3K
Preeti Puntambekar	NY	Neurology Physician	$123.4K	$0

Boston Children's Health Physicians, LLP — 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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