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

Why is the Medicaid comparison limited to Connecticut 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. Connecticut (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.

Thomas Defanti (NPI 1043239783)

Field	Value
Entity Type	Individual
Organization	Thomas Defanti
Address	75 Swantown Hl
City	North Stonington
State	CT
ZIP	06359
Taxonomy	Addiction Medicine (Psychiatry & Neurology) Physician
NPI Enumerated	July 19, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S0201	Partial hospitalization services, less than 24 hours, per diem	11,720	$300	$3.5M
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…	310	$100	$32K
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…	430	$70	$28.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	90	$110	$9.2K
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…	190	$50	$9.1K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Thomas Defanti — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0201	Partial hospitalization services, less than 24 hours, per diem	1	10	11,720	$300	$3.5M
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…	930	1,590	740	$50	$331.8K
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…	1,171	1,710	750	$30	$243.3K
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…	184	480	150	$90	$100.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	248	380	220	$70	$99.8K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prospect Chartercare Rwmc, LLC	RI	General Acute Care Hospital	$0	$57.1M
Connecticut Addiction Medicine, LLC	CT	Addiction Psychiatry Physician	$0	$21.1M
Peter Kassis	RI	Addiction Medicine (Family Medicine) Physician	$0	$12.2M
Prospect Chartercare Sjhsri, LLC	RI	General Acute Care Hospital	$0	$10.9M
Phoenix Houses Of New England, Inc.	RI	Substance Abuse Rehabilitation Facility	$0	$7.3M
St. Joseph Health Services Of Ri	RI	General Acute Care Hospital	$0	$5.9M
Roger Williams Medical Center	RI	Surgical Oncology Physician	$0	$5.4M
Sylvester Sviokla	RI	Addiction Medicine (Family Medicine) Physician	$0	$4.2M
Matthew Downey	RI	Pediatric Dentistry	$0	$2.8M
Prospect Chartercare Rwmc, LLC	RI	Internal Medicine Physician	$0	$2.4M

Nearby Providers

Other providers in the same ZIP code as Thomas Defanti, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stonington Behavioral Health Inc	CT	Psychiatric Hospital	$0	$51M
Behavioral Transformations Of Nc	CT	Community/Behavioral Health Agency	$0	$1.7M

Thomas Defanti — Billing Profile & Reimbursement Data

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Thomas Defanti — 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