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.

Middletown Medical PC (NPI 1902855828)

Field	Value
Entity Type	Organization
Organization	Middletown Medical PC
Address	111 Maltese Dr
City	Middletown
State	NY
ZIP	10940
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 8, 2006

Payer Source	Total Paid
Medicaid	$49.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

308 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…	156,360	$120	$19.1M
S9083	Global fee urgent care centers	51,060	$130	$6.8M
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…	52,190	$80	$4.4M
99204	The provider sees a new 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 provider…	11,780	$180	$2.1M
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…	23,830	$70	$1.7M
J0585	Injection, onabotulinumtoxina, 1 unit	1,570	$590	$920.6K
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…	7,250	$120	$870.5K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	16,240	$50	$828.1K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	4,380	$190	$828K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	24,050	$30	$697.5K

Showing 1–10 of 308

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

Middletown Medical PC — 10 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

308 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	12	200	340	$120	$1.7M
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…	42	340	1,090	$70	$1.4M
36475	In this procedure, the provider inserts a specially designed radiofrequency probe through the skin and destroys the wall of a diseased vein in an extremity. The provider reports this code for…	16	50	140	$1,050	$459.2K
U0005	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, cdc or non-cdc,…	41	300	1,710	$20	$458.6K
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.	199	610	310	$380	$397.9K
J0585	Injection, onabotulinumtoxina, 1 unit	10	80	150	$620	$380.1K
L3000	Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each	116	150	150	$200	$333.1K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	253	390	240	$450	$332.2K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	252	260	300	$170	$325.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	399	490	840	$90	$323.6K

Showing 1–10 of 308

Related Providers

Other providers that share a Tax Identification Number (TIN) with Middletown Medical PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Barnabas Hospital	NY	General Acute Care Hospital	$149.3K	$163.4M
Refuah Health Center Inc	NY	Federally Qualified Health Center (FQHC)	$0	$115.1M
Community Healthcare Network, Inc	NY	Case Management Agency	$0	$75.9M
Urban Health Plan, Inc.	NY	Federally Qualified Health Center (FQHC)	$0	$61.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Community Healthcare Network, Inc	NY	Federally Qualified Health Center (FQHC)	$0	$35.6M
Crystal Run Healthcare Physicians LLP	NY	General Practice Physician	$0	$34.1M
Community Health Connections, Inc.	MA	Federally Qualified Health Center (FQHC)	$0	$31.7M
Sbh Physicians, PC	NY	Internal Medicine Physician	$0	$31.5M
Emergency Physician Associates Of North Jersey P C	NJ	Emergency Medicine Physician	$0	$16.5M

Nearby Providers

Other providers in the same ZIP code as Middletown Medical PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Garnet Health Medical Center	NY	General Acute Care Hospital	$0	$45.1M
Restorative Management Corp	NY	Substance Abuse Rehabilitation Facility	$0	$18.5M
Joseph Racanelli	NY	Diagnostic Radiology Physician	$945.7K	$478.9K
Bonnie Seecharran	NY	Cardiovascular Disease Physician	$663K	$15.3K
Vivek Patil	NY	Vascular & Interventional Radiology Physician	$654.1K	$2.3K
David Lowenkron	NY	Specialist	$594.2K	$21.3K
Thomas Eanelli	NY	Radiation Oncology Physician	$568.2K	$390
Quazi Al-tariq	NY	Psychiatry Physician	$90.5K	$477.7K
Jagruti Gohel	NY	Family Medicine Physician	$408.6K	$119.9K
Elina Zaretsky	NY	Diagnostic Radiology Physician	$477.4K	$0

Middletown Medical PC — Billing Profile & Reimbursement Data

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Middletown Medical PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References