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.

Boston Children's Health Physicians Of New Jersey, LLC (NPI 1598213407)

Boston Children's Health Physicians Of New Jersey, LLC is a pediatrics physician provider located in Valhalla, New York. This profile covers 0 Medicare and 138 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	Boston Children's Health Physicians Of New Jersey, LLC
Address	40 Sunshine Cottage Rd
City	Valhalla
State	NY
ZIP	10595
Taxonomy	Pediatrics Physician
NPI Enumerated	September 20, 2016

Payer Source	Total Paid
Medicaid	$23.5M
Medicare	$0

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

138 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…	43,430	$140	$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…	57,440	$100	$5.5M
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…	16,490	$210	$3.5M
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.	35,190	$20	$809.3K
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…	5,520	$120	$656.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,190	$120	$617.5K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	4,530	$120	$521.1K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,880	$170	$478.2K
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…	4,190	$110	$465.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	2,920	$130	$376.2K

Showing 1–10 of 138

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

Boston Children's Health Physicians Of New Jersey, LLC — 8 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

138 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1,703	2,200	1,010	$130	$892.2K
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	13	40	90	$380	$367K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,142	1,320	140	$260	$334K
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…	238	19,110	360	$70	$321K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	31	150	230	$260	$312.4K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	5	10	50	$860	$273.3K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	38	90	190	$150	$260.8K
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…	1,016	1,750	510	$100	$221.6K
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…	120	16,550	220	$90	$186.8K
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…	154	1,150	480	$70	$178K

Showing 1–10 of 138

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Westchester County Health Care Corporation	NY	General Acute Care Hospital	$0	$64.5M
Blythedale Children's Hospital	NY	Children's Rehabilitation Hospital	$0	$44.4M
Nagwa Saleh	NY	Radiation Oncology Physician	$312.2K	$210.6K
Jay Doshi	NY	Cardiovascular Disease Physician	$445K	$9.3K
Gerald Zaidman	NY	Ophthalmology Physician	$119.5K	$285.5K
Liying Han	NY	Anatomic Pathology & Clinical Pathology Physician	$360.6K	$20.4K
Nigel Knox	NY	Pain Medicine (Anesthesiology) Physician	$302.8K	$0
Ma. Lourdes De Asis	NY	Allergy & Immunology Physician	$183.7K	$0
Dana Adkins	NY	Neurological Surgery Physician	$159.1K	$0
Shalabh Bobra	NY	Neuroradiology Physician	$138.5K	$8.6K

Boston Children's Health Physicians Of New Jersey, LLC — Billing Profile & Reimbursement Data

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Boston Children's Health Physicians Of New Jersey, 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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