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.

Oaks Integrated Care, Inc (NPI 1578967386)

Field	Value
Entity Type	Organization
Organization	Oaks Integrated Care, Inc
Address	79a Chestnut St
City	Lumberton
State	NJ
ZIP	08048
Taxonomy	Developmental Disabilities Clinic/Center
NPI Enumerated	October 22, 2014

Payer Source	Total Paid
Medicaid	$137M
Medicare	$0

Key Findings

This provider is effectively single-payer in scale: there is no Medicare billing on file and all reported public reimbursement is Medicaid, with lifetime Medicaid revenue of $137M. The absence of Medicare activity indicates the organization’s clinical and billing operations are focused on Medicaid-enrolled populations rather than dual-eligible or fee-for-service Medicare beneficiaries.

Revenue is extremely concentrated in a narrow set of service codes: the top three Medicaid codes account for 100.0% of this provider’s total Medicaid revenue. H2016 alone represents 96.2% of Medicaid revenue ($131.8M), T2021 represents 3.7% ($5.1M), and H0004 accounts for 0.0% ($8.7K), signaling dependence on a very small number of billed services.

The code mix points to a community-based developmental-disability service model: H2016 (Comprehensive community support services, per diem) is the dominant service line and suggests the provider operates large-scale community support programs. T2021 (Day habilitation, waiver; per 15 minutes) further indicates day habilitation programming as a secondary offering, while H0004 (Behavioral health counseling and therapy, per 15 minutes) is only a token component of billed services.

Competitive standing within New Jersey is mixed by service line. For H2016 the provider ranks #10 of 206 in-state (96th percentile) and is described as notably above typical state volume for that code, positioning it as a major statewide player in comprehensive community support services. By contrast, T2021 sits at #73 of 218 (67th percentile), a more typical mid-tier volume, and H0004 ranks #57 of 64 (11th percentile), indicating minimal activity relative to peers for behavioral therapy.

Operational scale is reflected in claim counts and throughput: the provider submitted 339.8K claims for H2016 and 39.2K claims for T2021, compared with only 101 claims for H0004. The very high H2016 claim volume underscores a sizable operational footprint in per-diem community support delivery rather than episodic or low-volume therapy services.

Average paid-per-unit highlights revenue drivers are volume-driven rather than high per-claim rates: H2016 has an average paid/claim of $388, T2021 averages $131 per paid unit, and H0004 averages $86 per paid unit. Given these rates, the outsized contribution of H2016 to overall revenue is primarily a function of claim volume (339.8K claims) rather than a superior per-claim reimbursement.

Concentration risk is material because 96.2% of Medicaid revenue is tied to a single code (H2016). Any policy changes, Medicaid rate adjustments, or shifts in utilization affecting comprehensive community support services could disproportionately impact the provider’s revenue base and financial stability.

The provider has an established presence: the NPI was enumerated on 2014-10-22 (~12 years ago), indicating it has operated under this billing identity for roughly a decade. Coupled with its high statewide rank on H2016, the tenure suggests the organization has scaled its community support services over multiple years within New Jersey.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	339,770	$390	$131.8M
T2021	Day habilitation, waiver; per 15 minutes	39,200	$130	$5.1M
H0004	Behavioral health counseling and therapy, per 15 minutes	100	$90	$8.7K

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

Oaks Integrated Care, Inc — 1 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	10	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	73	220	14,500	$170	$7.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	57	60	1,570	$70	$253.4K

Nearby Providers

Other providers in the same ZIP code as Oaks Integrated Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Change Counseling	NJ	Adolescent and Children Mental Health Clinic/Center	$0	$13.7M
Oaks Integrated Care, Inc	NJ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$11.9M
Burlington County Endoscopy Center LLC	NJ	Ambulatory Surgical Clinic/Center	$509.1K	$847.2K
Seth Keller	NJ	Neurology Physician	$122.2K	$0
Carole Thomas	NJ	Neurology Physician	$100.2K	$0

Oaks Integrated Care, Inc — Billing Profile & Reimbursement Data

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Oaks Integrated Care, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References