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.

Northeast Medical Group, Inc. (NPI 1043278351)

Key Findings

Field	Value
Entity Type	Organization
Organization	Northeast Medical Group, Inc.
Address	226 Mill Hill Avenue
City	Bridgeport
State	CT
ZIP	06610
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 3, 2006

Payer Source	Total Paid
Medicaid	$59.6M
Medicare	$0

This provider reports no Medicare billing on file and $59.6M in lifetime Medicaid revenue, making its current fiscal footprint effectively single‑payer Medicaid rather than a mixed Medicare/Medicaid practice. The absence of Medicare claims paired with substantial Medicaid receipts suggests contracting, patient mix, and care delivery are concentrated in Medicaid networks and programs.

Medicaid revenue is highly concentrated: the precomputed top three Medicaid codes account for 68.9% of total Medicaid revenue, driven by 99214 ($20.5M, 38.2%), 99213 ($10.8M, 20.1%), and 99232 ($5.6M, 10.5%). Those three codes are all evaluation-and-management services, indicating that office/outpatient E/M and hospital subsequent inpatient E/M are the primary revenue drivers.

The code mix points to a combined ambulatory and hospital-facing internal medicine operation: very high volumes of 99214 and 99213 indicate a large established-patient outpatient workload, while strong volumes and top ranks for 99232, 99233, 99222, 99223, and discharge codes (99239, 99238) indicate substantial inpatient/observation follow-up and discharge management activity. Diagnostic and procedural codes such as 93000 (ECG), 93306 (echocardiography), and 95810 (polysomnography) further expand the service profile to include cardiac diagnostics and sleep studies alongside core E/M services.

Competitive standing within Connecticut is dominant on key Medicaid codes: 99214 ranks #3 of 1589 providers (100th percentile; extreme outlier), 99213 ranks #6 of 1714 (100th percentile; extreme outlier), and 99232 ranks #1 of 169 (100th percentile; extreme outlier). Additional codes show analogous dominance—e.g., 99239 ranks #1 of 53 (100th percentile; extreme outlier), 99223 ranks #3 of 94 (98th percentile; extreme outlier), 99222 ranks #2 of 82 (99th percentile; extreme outlier)—collectively signaling a statewide high-volume leader for many core E/M services.

Operational scale is unusually large by claim counts: examples include 379.3K claims for 99214, 284.1K claims for 99213, and 268.3K claims for 99232, with other codes like 93000 at 54.8K claims. Those claim volumes are atypically high for a single clinician and suggest either a sizeable group practice, consolidated billing across multiple clinicians or sites, or integration with institutional/hospital billing flows—details that warrant verification when interpreting utilization or designing network contracting.

Preventive and pediatric well-care services are present but represent a small share relative to core E/M: 99391 ($957.8K) and 99392 ($602.1K) appear on the list along with 99393 ($266.8K), indicating some preventive medicine activity, yet these revenues are modest compared with the tens of millions driven by established-patient E/M codes. This mix implies primary care access for preventive services exists but is not the primary revenue engine.

Tenure in the enrollment database is long: the NPI was enumerated on 2006-05-03 (~20 years ago). Combined with the high Medicaid volumes and outlier ranks, the long enrollment suggests an established operation that has sustained high Medicaid activity over multiple years.

The extreme concentration of Medicaid revenue in a few E/M codes (top three = 68.9%) creates payer- and operational-level sensitivity: changes in coding guidance, prior authorization, or network contracting for those core codes could materially affect the provider’s revenue base. For payers and analysts, this concentration plus repeated extreme-outlier ranks argues for targeted audit of service settings, documentation practices, and contract terms rather than broad-based benchmarking comparisons.

Medicaid: Complete Services Breakdown

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

286 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…	379,350	$50	$20.5M
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…	284,060	$40	$10.8M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	268,290	$20	$5.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	127,810	$30	$3.8M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	28,070	$40	$1.1M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	31,290	$30	$1M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	15,580	$60	$981.2K
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…	19,810	$50	$970.7K
99391	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…	8,120	$120	$957.8K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	3,460	$230	$791.2K

Showing 1–10 of 286

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

Northeast Medical Group, Inc. — 13 of 25 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

286 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	80	130	690	$180	$4.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	92	110	1,520	$140	$3.4M
J0585	Injection, onabotulinumtoxina, 1 unit	11	20	1,530	$380	$1M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	7	10	590	$240	$989.9K
J0897	Injection, denosumab, 1 mg	10	10	930	$640	$923.7K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	4	50	870	$510	$687.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	6	80	790	$240	$650K
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…	24	70	570	$480	$626.7K
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.	26	80	990	$260	$592K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	13	20	180	$1,210	$568.6K

Showing 1–10 of 286

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Community And Family Services, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$63.8M
United Community And Family Services, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$24.8M
United Community And Family Services, Inc	CT	Federally Qualified Health Center (FQHC)	$0	$7.7M
Praveen Reddy	TX	Hematology & Oncology Physician	$1.8M	$0
Mallory Devona	CT	Counselor	$0	$1.2M
Philip Ginsburg	VT	Gastroenterology Physician	$628K	$0
Sandi-jo Galati	CT	Endocrinology, Diabetes & Metabolism Physician	$414K	$0
Ranee Angeli Lleva	CT	Endocrinology, Diabetes & Metabolism Physician	$347.2K	$0
Yi-hao Yu	CT	Endocrinology, Diabetes & Metabolism Physician	$301.5K	$0
Philip Goldberg	CT	Endocrinology, Diabetes & Metabolism Physician	$277K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bridgeport Hospital	CT	General Acute Care Hospital	$0	$287.1M
Collins Pharmacy Inc	CT	Durable Medical Equipment & Medical Supplies	$0	$59.1M
Liberation Programs Inc	CT	Adult Mental Health Clinic/Center	$274.3K	$17.3M
Quentin Medical Group, LLC	CT	Urgent Care Clinic/Center	$0	$9.3M
Recovery Network Of Programs, Inc	CT	Substance Use Disorder Rehabilitation Hospital Unit	$0	$7.2M
Mgm Family Dental	CT	Dental Clinic/Center	$0	$5.6M
Advanced Cardiovascular Specialists PC	CT	Cardiovascular Disease Physician	$0	$5.4M
Recovery Network Of Programs, Inc.	CT	Community/Behavioral Health Agency	$0	$5.3M
Recovery Network Of Programs, Inc.	CT	Community/Behavioral Health Agency	$0	$4.2M
State Of Connecticut	CT	Psychiatric Hospital	$0	$3.6M

Northeast Medical Group, Inc. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References