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.

Optum Medical Care Of New Jersey PC (NPI 1578665048)

Optum Medical Care Of New Jersey PC is a pediatrics physician provider located in New Hyde Park, New York. This profile covers 0 Medicare and 448 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	Optum Medical Care Of New Jersey PC
Address	1 Dakota Dr
City	New Hyde Park
State	NY
ZIP	11042
Taxonomy	Pediatrics Physician
NPI Enumerated	September 3, 2006

Payer Source	Total Paid
Medicaid	$219.4M
Medicare	$0

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

448 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…	809,660	$80	$65.6M
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…	919,460	$60	$54.2M
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…	47,670	$130	$6.1M
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.	216,340	$30	$5.8M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	51,110	$100	$5M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	110,390	$40	$4.7M
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…	46,100	$100	$4.5M
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…	25,660	$160	$4.1M
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…	43,330	$90	$3.7M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	34,760	$110	$3.6M

Showing 1–10 of 448

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

Optum Medical Care Of New Jersey PC — 25 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

448 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	173	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…	729	2,200	1,010	$130	$892.2K
36466	In this procedure, the provider injects a noncompounded foam sclerosing solution into multiple incompetent truncal veins under ultrasound guidance to guide the dispersion of foam, most commonly to…	8	20	80	$1,400	$532.2K
36465	In this procedure, the provider injects a noncompounded foam sclerosing solution into a single incompetent truncal vein of the extremity under ultrasound guidance to guide the dispersion of foam,…	17	70	260	$840	$463.1K
36475	In this procedure, the provider inserts a specially designed radiofrequency probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code for…	12	50	140	$1,050	$459.2K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	118	160	140	$720	$423.8K
J0897	Injection, denosumab, 1 mg	20	30	90	$1,180	$417.9K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	35	80	90	$1,300	$403.9K
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.	9	610	310	$380	$397.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	122	200	630	$150	$338K

Showing 1–10 of 448

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vivek Patil	NY	Vascular & Interventional Radiology Physician	$654.1K	$2.3K
Daniel Brodoff	NY	Diagnostic Radiology Physician	$474.2K	$0
John Chen	NY	Diagnostic Radiology Physician	$467.4K	$0
Garrett Dejesus	NY	Diagnostic Radiology Physician	$432.1K	$0
Steven Farkas	NY	Diagnostic Radiology Physician	$419.9K	$0
Mahesh Tekriwal	NJ	Cardiovascular Disease Physician	$343.9K	$0
Yevgeniy Latyshev	NJ	Cardiovascular Disease Physician	$278.5K	$0
Dena Miller	CT	Diagnostic Radiology Physician	$254.7K	$9.8K
Jenika Karcich	NJ	Diagnostic Radiology Physician	$226.4K	$40
William Hong	NJ	Cardiovascular Disease Physician	$224.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Freedom Care LLC	NY	Home Health Agency	$0	$3B
Northwell Health Laboratories	NY	Clinical Medical Laboratory	$48.5M	$198.2M
North Shore University Hospital	NY	Case Management Agency	$0	$166.6M
Prohealth Care Associates LLP	NY	Internal Medicine Physician	$0	$69.4M
Personal Touch Home Care Of New York, Inc.	NY	Early Intervention Provider Agency	$0	$19.3M
Nhpe, LLC	NY	Ambulatory Surgical Clinic/Center	$831.7K	$3M
Stuart Weinerman	NY	Endocrinology, Diabetes & Metabolism Physician	$2.3M	$2.3K
Jason Karp	NY	Pulmonary Disease Physician	$2.1M	$35.2K
Vishesh Agrawal	NY	Radiation Oncology Physician	$2.1M	$13K
Richard Furie	NY	Rheumatology Physician	$2.1M	$19.5K

Optum Medical Care Of New Jersey PC — 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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