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.

Phelps Memorial Hospital Association (NPI 1720185267)

Phelps Memorial Hospital Association is a general acute care hospital provider located in Sleepy Hollow, New York. This profile covers 0 Medicare and 208 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	Phelps Memorial Hospital Association
Address	701 N Broadway
City	Sleepy Hollow
State	NY
ZIP	10591
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 19, 2006

Payer Source	Total Paid
Medicaid	$20.2M
Medicare	$0

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

208 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	55,430	$60	$3.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10,310	$210	$2.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	8,480	$190	$1.6M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	16,870	$70	$1.1M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	3,050	$260	$805.2K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2,670	$210	$559.6K
H2001	Rehabilitation program, per 1/2 day	4,350	$120	$521.9K
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.	770	$660	$507.1K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,650	$290	$471.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	16,840	$20	$404.1K

Showing 1–10 of 208

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

Phelps Memorial Hospital Association — 2 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

208 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2036	Alcohol and/or other drug treatment program, per diem	81	100	10,060	$200	$4.9M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	114	340	1,090	$70	$1.4M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	214	210	2,850	$180	$1.1M
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…	313	1,510	1,010	$110	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	102	180	3,200	$90	$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…	974	2,200	1,010	$130	$892.2K
H0005	Alcohol and/or drug services; group counseling by a clinician	117	230	3,600	$60	$805.5K
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…	434	750	1,800	$80	$785.8K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	140	250	1,290	$110	$761.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	187	1,420	90	$130	$715.2K

Showing 1–10 of 208

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jay Doshi	NY	Cardiovascular Disease Physician	$445K	$9.3K
Faisal Nagarwala	NJ	Family Medicine Physician	$408.5K	$0
Jack Hershman	NY	Specialist	$284.9K	$14.3K
Haris Zafarullah	TN	Interventional Cardiology Physician	$252.6K	$0
Michael Platzman	NY	Family Medicine Physician	$222.2K	$2.2K
Alka Aggarwal	CT	Internal Medicine Physician	$220.9K	$0
Delong Liu	NY	Hematology & Oncology Physician	$134.9K	$9.3K
Craig Rogers	NY	Psychiatry Physician	$80.2K	$4.6K
Paul Nowak	NY	Emergency Medicine Physician	$71.5K	$0
Kevin Brown	NC	Otology & Neurotology Physician	$68.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ent And Allergy Associates LLP	NY	Otolaryngology Physician	$0	$117.8M
Family Home Health Care Inc	NY	Home Health Agency	$0	$58.5M
Cameron Budenz	NY	Otology & Neurotology Physician	$110.7K	$11.3M
Bridge Dermatopathology Services PLLC	NY	Clinical Medical Laboratory	$4.3M	$762.7K
Brian Gruber	NY	Physician Assistant	$523.2K	$0
Jozef Debiec	NY	Interventional Pain Medicine Physician	$514K	$0
Robert Shirinov	NY	Surgery Physician	$390.4K	$52.9K
Joseph Castellano	NY	Ophthalmology Physician	$71.6K	$367.6K
Deya Jourdy	NY	Otolaryngology Physician	$402.6K	$2.2K
Craig Zalvan	NY	Otolaryngology Physician	$401.4K	$750

Phelps Memorial Hospital Association — Billing Profile & Reimbursement Data

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Phelps Memorial Hospital Association — 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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