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.

Neighborhood Health, Inc. (NPI 1043544489)

Neighborhood Health, Inc. is a general practice physician provider located in Torrington, Connecticut. This profile covers 0 Medicare and 113 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	Neighborhood Health, Inc.
Address	59 Field Street
City	Torrington
State	CT
ZIP	06790
Taxonomy	General Practice Physician
NPI Enumerated	October 1, 2009

Payer Source	Total Paid
Medicaid	$9.8M
Medicare	$0

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

113 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	33,200	$60	$2.1M
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…	37,250	$50	$2M
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.	26,380	$50	$1.3M
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…	49,820	$20	$946.6K
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…	19,190	$40	$786.6K
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.	19,420	$30	$563.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	18,530	$10	$240.9K
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…	3,820	$60	$214.1K
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…	8,330	$20	$199.9K
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…	3,770	$40	$150.9K

Showing 1–10 of 113

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

Neighborhood Health, Inc. — 2 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

113 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	27	130	520	$330	$5.9M
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.	36	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.	38	110	1,520	$140	$3.4M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	48	60	3,070	$100	$907.8K
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…	17	80	790	$240	$650K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	33	50	1,820	$100	$515.7K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	27	30	1,560	$160	$444.1K
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…	41	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…	115	1,710	750	$30	$243.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	29	50	1,060	$50	$230.5K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nauman Piracha	CT	Hospitalist Physician	$489.5K	$104.3K
Thomas Toothaker	CT	Neurology Physician	$135.3K	$0
Wilner Samson	CT	Internal Medicine Physician	$71.7K	$0
Miralle Yaakov-blechman	CT	Emergency Medicine Physician	$66.2K	$0
Srinath Kadimi	CT	Neurology Physician	$64.9K	$0
Roger Jou	CT	Psychiatry Physician	$21.7K	$0
Linton Kinlock	CT	Psychiatric/Mental Health Nurse Practitioner	$3.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Charlotte Hungerford Hospital	CT	General Acute Care Hospital	$0	$89.4M
Mccall Foundation, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$19.8M
Community Health And Wellness Center Of Greater Torrington Inc	CT	Primary Care Clinic/Center	$0	$13.2M
Community Health & Wellness Center Of Greater Torrington	CT	Federally Qualified Health Center (FQHC)	$0	$7.4M
Northwest Hills Pediatrics PC	CT	Pediatric Adolescent Medicine Physician	$0	$5.7M
The Maria Seymour Brooker Memorial, Inc.	CT	Pediatric Dentistry	$0	$4.6M
Icare Dental LLC	CT	General Practice Dentistry	$0	$3.9M
Mccall Foundation, Inc.	CT	Substance Abuse Rehabilitation Facility	$0	$3.9M
Synergy Advanced Healthcare LLC	CT	Primary Care Nurse Practitioner	$0	$3.5M
Litchfield County Pediatrics, L.L.C.	CT	Pediatric Adolescent Medicine Physician	$0	$3.5M

Neighborhood Health, Inc. — Billing Profile & Reimbursement Data

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Neighborhood Health, Inc. — 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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