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 Jersey for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Jersey 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 Jersey (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.

Dungarvin New Jersey, LLC - Somerset Day Program (NPI 1922495340)

Field	Value
Entity Type	Organization
Organization	Dungarvin New Jersey, LLC - Somerset Day Program
Address	2550 Us Highway 1
City	North Brunswick
State	NJ
ZIP	08902
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	April 23, 2015

Payer Source	Total Paid
Medicaid	$100.3M
Medicare	$0

Key Findings

Dungarvin New Jersey, LLC - Somerset Day Program is an established intellectual and developmental disabilities community-based residential treatment facility operating in North Brunswick, NJ, with an NPI enumerated 2015-04-23 (~11 years ago). Its recorded lifetime billing is effectively single-payer: no Medicare billing on file and $100.3M in lifetime Medicaid revenue, indicating the provider’s operations are concentrated in publicly funded Medicaid programs.

Revenue is highly concentrated in a very small set of Medicaid codes: the top 3 Medicaid codes by revenue account for 100.0% of this provider's total Medicaid revenue, with H2016 representing $77.8M (77.5%) and T2021 representing $22.5M (22.4%). The remaining listed codes (A0090 at $56.8K, H0004 at $5.5K) together make up a de minimis share of reported Medicaid revenue.

The service mix implied by the dominant codes points to a day-program and community-support model: H2016 (Comprehensive community support services, per diem) and T2021 (Day habilitation, waiver; per 15 minutes) together drive virtually all revenue, which suggests the provider bills primarily for per-diem community supports and time-based day habilitation rather than medical or Medicare-type services. The presence of A0090 (non-emergency transportation, per mile) and small H0004 (behavioral health counseling, per 15 minutes) line items is consistent with ancillary supports offered alongside day habilitation.

Because there is no Medicare billing on file, the provider is effectively single-payer from a revenue perspective and therefore materially dependent on Medicaid policy, rates, and waiver design. That concentration increases exposure to reimbursement or waiver changes affecting H2016 and T2021 since those two codes together constitute the overwhelming majority of reported Medicaid revenue.

Competitive standing within New Jersey is mid-to-upper for the provider’s two largest codes: H2016 ranks #31 of 206 providers in-state (85th percentile) and T2021 ranks #25 of 218 providers in-state (89th percentile), both described as typical, unremarkable volume for this code. These rankings indicate a solid state-level presence in community supports and day habilitation but do not position the provider as a statewide dominant outlier; A0090 ranks #112 of 227 (51th percentile; typical, unremarkable volume for this code) and H0004 ranks #55 of 64 (14th percentile; typical, unremarkable volume for this code), reflecting modest to low engagement in transportation and behavioral health counseling relative to peers.

Volumes for the major codes are explicitly described as typical, unremarkable volume for this code despite their large contribution to the provider’s revenue, suggesting the provider achieves high absolute Medicaid revenue by concentrating service delivery into commonly billed Medicaid modalities rather than by exhibiting extreme outlier activity. This pattern aligns with a high-throughput day-program model rather than unusual billing behavior.

Operational risk considerations follow from the concentrated revenue mix: with H2016 and T2021 accounting for 77.5% and 22.4% of Medicaid revenue respectively, any changes to per-diem rates, waiver eligibility, or service definitions for these codes would disproportionately affect the provider’s financials. Analysts should prioritize monitoring state Medicaid rate-setting and waiver policy activity for community support services and day habilitation when assessing this entity.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2016	Comprehensive community support services, per diem	168,340	$460	$77.8M
T2021	Day habilitation, waiver; per 15 minutes	128,350	$180	$22.5M
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	8,110	$10	$56.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	120	$50	$5.5K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other New Jersey providers billing the same CPT/HCPCS codes.

Claims Volume vs. New Jersey Distribution

Dungarvin New Jersey, LLC - Somerset Day Program — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2016	Comprehensive community support services, per diem	31	210	23,310	$490	$41.9M
T2021	Day habilitation, waiver; per 15 minutes	25	220	14,500	$170	$7.7M
H0004	Behavioral health counseling and therapy, per 15 minutes	55	60	1,570	$70	$253.4K
A0090	Non-emergency transportation, per mile - vehicle provided by individual (family member, self, neighbor) with vested interest	112	230	7,800	$10	$218.8K

Nearby Providers

Other providers in the same ZIP code as Dungarvin New Jersey, LLC - Somerset Day Program, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Second Inning Adult Day Care Center	NJ	Adult Day Care Clinic/Center	$0	$32.1M
Broadway Group Home LLC	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$24.4M
Sterling Adult Day Care Center, LLC	NJ	Adult Day Care Clinic/Center	$0	$21.6M
Preferred Home Health Care & Nursing Services, Inc.	NJ	Home Health Agency	$0	$17.6M
Meetu Soni	NJ	Pediatric Dentistry	$0	$17.1M
C & M Health Services LLC	NJ	Home Health Agency	$0	$16.7M
Astera Housing Inc	NJ	Home Health Agency	$0	$15.6M
Expo Signature Home Care LLC	NJ	Home Health Agency	$0	$12.5M
Maxim Sulla,dds, Professional Association	NJ	Pediatric Dentistry	$0	$8.2M
North Brunswick Township Board Of Education	NJ	Local Education Agency (LEA)	$0	$8.1M

Dungarvin New Jersey, LLC - Somerset Day Program — Billing Profile & Reimbursement Data

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Dungarvin New Jersey, LLC - Somerset Day Program — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References