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.

Premium Health Inc (NPI 1609129402)

Premium Health Inc is a federally qualified health center (fqhc) provider located in Brooklyn, New York. This profile covers 0 Medicare and 90 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	Premium Health Inc
Address	1010 Mcdonald Ave
City	Brooklyn
State	NY
ZIP	11230
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 18, 2012

Payer Source	Total Paid
Medicaid	$85.4M
Medicare	$0

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

90 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	328,540	$150	$49M
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…	38,920	$160	$6.1M
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…	36,930	$160	$5.9M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	35,730	$150	$5.3M
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…	19,100	$130	$2.6M
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…	13,630	$150	$2M
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…	11,930	$170	$2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	13,440	$150	$1.9M
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	22,210	$60	$1.2M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	7,510	$140	$1.1M

Showing 1–10 of 90

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

Premium Health Inc — 12 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

90 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	14	40	70	$3,040	$1.5M
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…	866	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…	80	2,200	1,010	$130	$892.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	704	750	1,800	$80	$785.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	500	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…	22	19,110	360	$70	$321K
90846	A provider meets with the patient’s family without the patient present to counsel the family on the psychological issues affecting the patient and the family.	31	270	360	$110	$319.1K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	18	120	700	$40	$203.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	97	440	530	$80	$199.7K
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…	143	16,550	220	$90	$186.8K

Showing 1–10 of 90

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sun River Health Inc.	NY	Federally Qualified Health Center (FQHC)	$0	$546.7M
North Shore-lij Medical PC	NY	Urology Physician	$0	$388.1M
Prisma Health Medical Group-midlands	SC	Orthopaedic Surgery Physician	$0	$8.7M
Edward Bennett	NY	Internal Medicine Physician	$152.7K	$6.7M
Eric Berkowitz	NY	Vascular & Interventional Radiology Physician	$2.6M	$1.2M
Eric Shakin	NY	Ophthalmology Physician	$3.3M	$291.7K
Lynda Piboon	NY	Obstetrics & Gynecology Physician	$62.2K	$3.1M
Stuart Weinerman	NY	Endocrinology, Diabetes & Metabolism Physician	$2.3M	$2.3K
Jason Karp	NY	Pulmonary Disease Physician	$2.1M	$35.2K
Richard Furie	NY	Rheumatology Physician	$2.1M	$19.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Home Health Care Services Of Ny	NY	Home Health Agency	$0	$589M
Quality Healthcare, Inc.	NY	Home Health Agency	$0	$217.5M
Quality Family Care, LLC.	NY	Home Health Agency	$0	$180.2M
Marks Homecare Cdpap, LLC	NY	In Home Supportive Care Agency	$0	$164.9M
Summit Home Health Care	NY	Home Health Agency	$0	$148.9M
Global Home Care Inc.	NY	Home Health Agency	$0	$132M
Supportive Home Care LLC	NY	Home Health Agency	$0	$116.7M
Future Care Health Services	NY	Home Health Agency	$0	$105.7M
Homecare Services For Ind. Living	NY	Home Health Agency	$0	$103.4M
Welcome Care Inc	NY	Home Health Agency	$0	$98.8M

Premium Health Inc — Billing Profile & Reimbursement Data

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Premium Health 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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