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.

New Jersey Medical And Health Associates,llc (NPI 1558673582)

New Jersey Medical And Health Associates,llc is a internal medicine physician provider located in Hoboken, New Jersey. This profile covers 0 Medicare and 163 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	New Jersey Medical And Health Associates,llc
Address	308 Willow Ave
City	Hoboken
State	NJ
ZIP	07030
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 7, 2010

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

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

163 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…	51,090	$50	$2.5M
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…	31,720	$40	$1.2M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9,710	$60	$563.1K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	8,120	$50	$438.4K
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…	13,190	$20	$263.9K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	19,850	$10	$238.2K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	3,040	$60	$191.8K
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…	2,940	$60	$185.5K
99349	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	7,270	$20	$152.6K
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.	5,320	$30	$138.4K

Showing 1–10 of 163

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

New Jersey Medical And Health Associates,llc — 6 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

163 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	80	280	360	$560	$567.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	208	330	650	$200	$465.1K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	49	90	980	$230	$347.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	90	170	200	$470	$313.6K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	57	110	250	$540	$292.2K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	13	100	1,110	$80	$274.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	16	140	1,230	$70	$260.9K
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…	148	4,450	740	$40	$229.8K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	85	130	360	$220	$226.3K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	25	50	290	$120	$205.7K

Showing 1–10 of 163

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
G&s Medical Associates LLC	NJ	Internal Medicine Physician	$0	$17M
Vincent Arloro	NJ	Podiatrist	$5.7M	$0
Ramzan Zakir	NJ	Interventional Cardiology Physician	$1.7M	$1.2K
Ajay Agarwala	NY	Cardiovascular Disease Physician	$1.1M	$288.1K
Gammal Hassanien	NJ	Internal Medicine Physician	$85.2K	$775.1K
Mohammad Zubair	NJ	Pulmonary Disease Physician	$478.4K	$114.7K
Vladimir Rukshin	NJ	Cardiovascular Disease Physician	$516.6K	$0
Simon Badin	NJ	Hematology & Oncology Physician	$467.2K	$0
Rakesh Passi	NJ	Cardiovascular Disease Physician	$410.8K	$0
Khanh Nguyen	MD	Emergency Medicine Physician	$357.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Humc Opco LLC	NJ	General Acute Care Hospital	$0	$57.3M
Progressive Option Support Services	NJ	Community/Behavioral Health Agency	$0	$9.5M
Pdi Health LLC	NJ	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.7M	$385.8K
Pdi Health LLC	NJ	Mobile Radiology Clinic/Center	$375.8K	$107.9K
Jeremy Davis	NJ	Primary Care Nurse Practitioner	$282.9K	$0
Juliana Paternina	NJ	Foot & Ankle Surgery Podiatrist	$230.4K	$0
Mamatha Gowda	NJ	Diagnostic Radiology Physician	$92.8K	$28.6K
Latrice Akuamoah	NJ	Pain Medicine (Anesthesiology) Physician	$97.5K	$19.7K
Tyler Mollet	NJ	Family Nurse Practitioner	$113.1K	$0
Robert Strell	NJ	Physical Medicine & Rehabilitation Physician	$101.8K	$0

New Jersey Medical And Health Associates,llc — 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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