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.

Zufall Health Center, Inc (NPI 1548515091)

Zufall Health Center, Inc is a federally qualified health center (fqhc) provider located in Dover, New Jersey. This profile covers 0 Medicare and 135 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	Zufall Health Center, Inc
Address	18 W Blackwell St
City	Dover
State	NJ
ZIP	07801
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	July 20, 2012

Payer Source	Total Paid
Medicaid	$10.6M
Medicare	$0

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

135 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	34,390	$190	$6.6M
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…	105,760	$20	$2M
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.	22,840	$20	$502.4K
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…	12,130	$20	$242.6K
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…	3,660	$40	$142.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	2,260	$50	$108.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	3,420	$30	$88.8K
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…	3,330	$30	$83.3K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	10,940	$10	$76.6K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	4,470	$20	$76K

Showing 1–10 of 135

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

Zufall Health Center, Inc — 8 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

135 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	4	110	4,060	$170	$1.5M
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…	289	720	1,690	$80	$629.2K
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	9	10	370	$50	$554.3K
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…	29	4,450	740	$40	$229.8K
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…	180	3,790	580	$60	$204K
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…	26	430	550	$50	$190.5K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	65	220	900	$1	$180.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	149	550	280	$120	$131.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	125	190	320	$70	$127.9K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	79	180	320	$10	$116.9K

Showing 1–10 of 135

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Froncek	NJ	Rheumatology Physician	$118.8K	$0
Anish Sheth	NJ	Gastroenterology Physician	$99.5K	$0
Isao Iwata	NJ	Geriatric Medicine (Internal Medicine) Physician	$81.6K	$0
Julia Cornett	NJ	Infectious Disease Physician	$5.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	NJ	Home Health Agency	$0	$11.8M
Steven Golombek	NJ	Rheumatology Physician	$4.2M	$0
Jeanne Pare	NJ	Rheumatology Physician	$1.4M	$0
City Medical Transport Corporation	NJ	Non-emergency Medical Transport (VAN)	$1.1M	$70.8K
Eric Mann	NJ	Ophthalmology Physician	$858.5K	$46.4K
Vincent Gengaro Iii	NJ	Physical Therapist	$382.2K	$0
Stephen Bigelsen	NJ	Allergy & Immunology (Internal Medicine) Physician	$152.6K	$0
Joel Spielman	NJ	Orthopaedic Surgery Physician	$147.3K	$0
Bivin Thomas	NJ	Internal Medicine Physician	$65.7K	$0
Roger Warn	NJ	Registered Dietitian	$11.9K	$0

Zufall Health 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

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