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.

Open Door Family Medical Center, Inc. (NPI 1467487637)

Field	Value
Entity Type	Organization
Organization	Open Door Family Medical Center, Inc.
Address	165 Main St
City	Ossining
State	NY
ZIP	10562
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$35.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

125 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…	158,660	$100	$15.7M
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,…	34,960	$90	$3M
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…	34,560	$60	$2.1M
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…	13,910	$110	$1.5M
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	11,300	$110	$1.2M
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…	13,000	$90	$1.2M
99441	N/A	14,340	$70	$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…	9,780	$100	$1M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	9,970	$100	$986.6K
D0120	Periodic oral evaluation - established patient	48,350	$20	$822K

Showing 1–10 of 125

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

Open Door Family Medical Center, Inc. — 17 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

125 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	21	80	360	$550	$11.6M
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…	81	1,510	1,010	$110	$1.1M
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…	1,924	2,200	1,010	$130	$892.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	349	1,320	140	$260	$334K
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…	63	19,110	360	$70	$321K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	385	410	1,190	$20	$209.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	31	120	700	$40	$203.2K
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…	523	16,550	220	$90	$186.8K
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…	54	1,150	480	$70	$178K
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…	57	1,420	490	$70	$176.8K

Showing 1–10 of 125

Related Providers

Other providers that share a Tax Identification Number (TIN) with Open Door Family Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Open Door Family Medical Center Inc	NY	Federally Qualified Health Center (FQHC)	$0	$19.5M
Andrew Rosenson	IL	Diagnostic Radiology Physician	$3.1M	$193.2K
Jesus Lago	NY	Psychiatry Physician	$235.4K	$111.1K

Nearby Providers

Other providers in the same ZIP code as Open Door Family Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hudson Valley Care Coalition	NY	Case Management Agency	$0	$90.7M
Hudson Pharmacy & Surgical Supplies Inc	NY	Community/Retail Pharmacy	$281.7K	$201.9K
Dean Cummins	NY	Ophthalmology Physician	$137.3K	$0
Charles Abate	NY	Pulmonary Disease Physician	$120.6K	$0
Healthsmart Inc	NY	Pharmacy	$55.4K	$0

Open Door Family Medical Center, Inc. — Billing Profile & Reimbursement Data

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Open Door Family Medical Center, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References