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.

Neighborhood Health Center Of Wny, Inc. (NPI 1881789014)

Field	Value
Entity Type	Organization
Organization	Neighborhood Health Center Of Wny, Inc.
Address	155 Lawn Ave
City	Buffalo
State	NY
ZIP	14207
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$33.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

196 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…	408,380	$30	$11M
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…	238,260	$30	$6.2M
D0120	Periodic oral evaluation - established patient	73,820	$20	$1.3M
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	19,620	$50	$981K
T1015	Clinic visit/encounter, all-inclusive	100,770	$10	$906.9K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	36,030	$20	$864.7K
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…	10,620	$80	$796.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	33,450	$20	$735.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	15,550	$40	$684.4K
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…	12,120	$60	$678.7K

Showing 1–10 of 196

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

Neighborhood Health Center Of Wny, Inc. — 21 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

196 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…	270	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…	263	2,200	1,010	$130	$892.2K
T1015	Clinic visit/encounter, all-inclusive	2	120	1,230	$140	$539.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	79	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…	17	19,110	360	$70	$321K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	33	50	340	$80	$246K
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…	69	1,750	510	$100	$221.6K
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…	13	120	700	$40	$203.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	66	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…	10	16,550	220	$90	$186.8K

Showing 1–10 of 196

Neighborhood Health Center Of Wny, Inc. — Billing Profile & Reimbursement Data

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Neighborhood Health Center Of Wny, 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

Frequently Asked Questions

References