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.

St. Joseph's Healthcare, Inc. (NPI 1497791297)

St. Joseph's Healthcare, Inc. is a internal medicine physician provider located in Paterson, New Jersey. This profile covers 0 Medicare and 279 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	St. Joseph's Healthcare, Inc.
Address	703 Main St
City	Paterson
State	NJ
ZIP	07503
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$31.7M
Medicare	$0

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

279 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…	92,780	$60	$5.2M
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…	55,800	$80	$4.6M
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…	27,850	$120	$3.3M
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…	26,410	$70	$1.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	42,090	$30	$1.3M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	5,050	$180	$889.2K
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…	6,710	$110	$757.8K
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…	19,150	$40	$727.8K
99203	The provider sees a new 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 provider…	7,960	$80	$653K
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…	4,770	$120	$591K

Showing 1–10 of 279

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.

Claims Volume vs. New Jersey Distribution

St. Joseph's Healthcare, Inc. — 19 of 25 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. New Jersey median

279 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	81	130	3,180	$60	$4.2M
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.	313	320	580	$230	$4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	100	150	3,680	$30	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	70	120	900	$20	$971.9K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	70	120	940	$20	$957.4K
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	21	50	400	$10	$839.8K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	63	90	630	$30	$806.2K
86769	The lab analyst performs a multiple–step immunoassay to evaluate the patient’s serum for antibodies to severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), which causes coronavirus disease…	26	60	280	$40	$728.3K
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…	607	720	1,690	$80	$629.2K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	73	140	870	$10	$605.2K

Showing 1–10 of 279

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs Medical Group PC	NJ	Internal Medicine Physician	$0	$10.1M
Jumana Chatiwala	NJ	Internal Medicine Physician	$1.3M	$0
Gerald Ngo	NJ	Cardiovascular Disease Physician	$414.6K	$0
Nawar Al Obaidi	NJ	Internal Medicine Physician	$400.4K	$11K
Michael Esposito	NJ	Urology Physician	$376.9K	$0
Saddad Toor	NJ	Cardiovascular Disease Physician	$312K	$39.1K
Mutahar Ahmed	NJ	Urology Physician	$320.2K	$0
Gregory Lovallo	NJ	Urology Physician	$307.9K	$0
Rimvida Obeleniene	NJ	Cardiovascular Disease Physician	$284.4K	$0
Thomas Christiano	NJ	Urology Physician	$277.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs University Medical Center Inc.	NJ	General Acute Care Hospital	$0	$322.3M
St. Joseph's Emergency Physicians Inc	NJ	Emergency Medical Services (Emergency Medicine) Physician	$0	$24.2M
Fayrouz Pediatric LLC	NJ	Pediatrics Physician	$0	$13.3M
St. Josephs Hospital And Medical Center	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$13.2M
Simeon Dialysis LLC	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.9M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Ellsworth Wright	NJ	Emergency Medicine Physician	$247.3K	$0
Orestes Sanchez	NJ	Diagnostic Radiology Physician	$225.5K	$0
Edward Milman	NJ	Diagnostic Radiology Physician	$221.9K	$0
Prashant Parashurama	NJ	Diagnostic Radiology Physician	$131.9K	$0

St. Joseph's Healthcare, 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

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