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.

Optum Medical Care, P.C. (NPI 1982643003)

Optum Medical Care, P.C. is a cardiovascular disease physician provider located in Mount Kisco, New York. This profile covers 0 Medicare and 368 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	Optum Medical Care, P.C.
Address	90 South Bedford Rd
City	Mount Kisco
State	NY
ZIP	10549
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$105.1M
Medicare	$0

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

368 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…	290,520	$120	$34.3M
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…	95,090	$170	$15.9M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	13,970	$220	$3.1M
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…	16,850	$160	$2.6M
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	11,940	$220	$2.6M
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…	13,530	$180	$2.5M
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…	9,300	$220	$2M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	13,630	$140	$1.9M
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	10,910	$170	$1.9M
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…	12,180	$140	$1.7M

Showing 1–10 of 368

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

Optum Medical Care, P.C. — 17 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

368 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	170	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…	59	340	1,090	$70	$1.4M
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…	1,320	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…	1,892	2,200	1,010	$130	$892.2K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	93	140	360	$130	$492.1K
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,…	80	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.	501	610	310	$380	$397.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	161	200	630	$150	$338K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	135	200	470	$150	$336.9K
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	15	50	420	$110	$334.5K

Showing 1–10 of 368

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crystal Run Healthcare Physicians LLP	NY	General Practice Physician	$0	$34.1M
Long Island Digestive Endoscopy Center, LLC	NY	Ambulatory Surgical Clinic/Center	$1.6M	$1.4M
Matthew Pomykala	NY	Ophthalmology Physician	$1.7M	$1M
Howard Charles	NY	Ophthalmology Physician	$2.7M	$13.9K
Changping Jia	NY	Nuclear Imaging & Therapy Physician	$2.2M	$58.7K
Eric Fitz	NY	Ophthalmology Physician	$2.2M	$1.3K
Alexandra Pappas	NY	Ophthalmology Physician	$1.8M	$14.4K
Jeffrey Halaas	NY	Hematology & Oncology Physician	$1.6M	$0
Shaya Ansari	NY	Diagnostic Radiology Physician	$1.5M	$1K
Saad Yousuf	NY	Hematology & Oncology Physician	$1M	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hcs Home Care Of Westchester Inc	NY	Home Health Agency	$0	$40.5M
Starnet Emergency Services	NY	Land Ambulance	$2.8M	$2.9M
Craig Fern	NY	Specialist	$4.1M	$276.3K
Daniel Mark	NY	Radiation Oncology Physician	$2.2M	$0
Raisa Katz	NY	Vascular & Interventional Radiology Physician	$1M	$345.9K
Mt Kisco Surgery Center LLC	NY	Ambulatory Surgical Clinic/Center	$702.8K	$22.4K
Henry Janssen	NY	Diagnostic Radiology Physician	$672.5K	$0
Melanie Warycha	NY	MOHS-Micrographic Surgery Physician	$643.2K	$0
Daniel Brodoff	NY	Diagnostic Radiology Physician	$474.2K	$0
John Chen	NY	Diagnostic Radiology Physician	$467.4K	$0

Optum Medical Care, P.C. — Billing Profile & Reimbursement Data

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Optum Medical Care, P.C. — 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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