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.

Hartford Healthcare Medical Group, Inc (NPI 1043561301)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hartford Healthcare Medical Group, Inc
Address	1290 Silas Deane Hwy
City	Wethersfield
State	CT
ZIP	06109
Taxonomy	Surgery Physician
NPI Enumerated	September 27, 2012

Payer Source	Total Paid
Medicaid	$22.4M
Medicare	$0

This entity reports no Medicare billing on file and $22.4M in lifetime Medicaid revenue, effectively making it a Medicaid-focused billing entity in available claims data rather than a dual‑payer practice. The absence of Medicare activity should be considered when comparing its scale and service mix to peers that bill both programs.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 90.8% of this provider's total Medicaid revenue, led by 99214 at $13.2M (60.2%), followed by 99213 at $6.4M (29.2%), and J0585 at $297.4K (1.4%). This concentration indicates that a very small set of codes drives nearly all Medicaid receipts.

The code mix is dominated by office/outpatient E/M services—99214 and 99213 are the top revenue generators—signaling an operations profile centered on high-volume ambulatory evaluation and management visits. Given the provider taxonomy of Surgery Physician, this pattern is consistent with a surgical practice that bills heavily for clinic‑based evaluation, follow‑up, and outpatient management rather than for high-revenue operating room procedures in the Medicaid dataset.

Competitive standing on key ambulatory codes is exceptionally strong in-state: 99214 ranks #5 of 1589 providers in Connecticut (100th percentile; extreme outlier) and 99213 ranks #13 of 1714 providers (99th percentile; extreme outlier). These rankings indicate the provider is a dominant statewide participant for high‑level and mid‑level established patient office visits. In contrast, J0585 ranks #14 of 19 (28th percentile), a typical volume position for that injection code.

Preventive and vaccination activity is notable: 90686 shows 11.9K claims for $107.4K (0.5% of Medicaid revenue) and ranks #17 of 332 providers in-state (95th percentile), while 90460 accounts for 5.1K claims and $142.6K (0.7% of revenue) and ranks #68 of 244 (72nd percentile). These volumes point to substantial influenza and pediatric vaccine throughput as part of the outpatient visit mix.

The dataset includes inpatient and diagnostic E/M and cardiology services (for example, 99232, 99233, 99223, 99239, 93306, 93010, 93000), but each of these codes contributes a relatively small share of total Medicaid revenue. That suggests the practice provides some hospital follow‑up and diagnostic testing in addition to its dominant ambulatory clinic work, though those services are secondary revenue streams.

The provider has a stable administrative tenure with NPI enumeration on 2012-09-27 (~14 years ago), indicating it has been an established billing entity over a multi‑year period. Combined with $22.4M in Medicaid revenue and extreme outlier ranking on core E/M codes, this points to sustained, high-volume outpatient operations within Connecticut Medicaid.

Operational and payer implications follow from the extreme revenue concentration: with 90.8% of Medicaid revenue coming from three codes, the provider is exposed to utilization or policy shifts that affect office visit reimbursement or visit volume. From a contracting and network strategy perspective, the practice’s leverage and value to Medicaid plans will be driven mainly by its capacity to deliver large volumes of established patient office visits and vaccination services.

Medicaid: Complete Services Breakdown

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

176 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…	253,390	$50	$13.2M
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…	172,960	$40	$6.4M
J0585	Injection, onabotulinumtoxina, 1 unit	560	$530	$297.4K
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…	3,310	$80	$271.7K
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…	11,490	$20	$218.4K
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…	4,500	$50	$207.1K
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…	2,200	$80	$176.2K
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.	5,090	$30	$142.6K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	11,930	$10	$107.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	5,050	$20	$106.1K

Showing 1–10 of 176

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

Hartford Healthcare Medical Group, Inc — 3 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

176 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	33	40	23,540	$140	$3.7M
J0585	Injection, onabotulinumtoxina, 1 unit	14	20	1,530	$380	$1M
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,…	40	50	870	$510	$687.2K
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…	16	20	180	$1,210	$568.6K
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…	40	100	1,120	$120	$564.2K
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…	5	1,590	740	$50	$331.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	113	130	600	$30	$329.2K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	56	60	9,020	$20	$324.9K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	40	40	730	$160	$282.9K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	33	40	290	$460	$264.7K

Showing 1–10 of 176

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hartford Hospital	CT	General Acute Care Hospital	$0	$316.3M
The Hospital Of Central Connecticut At New Britain General And Bradley	CT	General Acute Care Hospital	$0	$220M
Hartford Healthcare Medical Group Specialists, PLLC	CT	Surgery Physician	$0	$46M
Hartford Hospital	CT	Surgery Physician	$0	$27.5M
The Hospital Of Central Connecticut At New Britain General And Bradley	CT	Hospitalist Physician	$0	$22.2M
Inhouse Care LLC	CT	Primary Care Clinic/Center	$0	$3.4M
Philip Simkovitz	CT	Critical Care Medicine (Internal Medicine) Physician	$589.2K	$506K
Pouyan Changizzadeh	CT	Hematology & Oncology Physician	$1.1M	$0
Edward Fitzpatrick	CT	Ophthalmology Physician	$757.6K	$0
Nikia Bray	CT	Family Nurse Practitioner	$58.9K	$557K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caregiver Homes Of Connecticut, Inc	CT	Case Management Agency	$0	$112.5M
Medical Management Plus	CT	Home Health Agency	$0	$21.5M
Hartford Healthcare At Home, Inc	CT	Home Health Agency	$0	$19.2M
Connecticut Imaging Partners, LLC	CT	Diagnostic Radiology Physician	$0	$4.6M
Prime Healthcare, PC	CT	Internal Medicine Physician	$0	$4.3M
1271972 LLC	CT	Urgent Care Clinic/Center	$0	$4M
Dr. James Hai T. Nguyen, LLC	CT	General Practice Dentistry	$0	$1.5M
Dr. Nguyen Associates LLC	CT	Optometrist	$0	$1.4M
Minds Cornerstone LLC	CT	Community/Behavioral Health Agency	$0	$1.3M
Laura Miner	CT	Pediatric Dentistry	$0	$1.3M

Hartford Healthcare Medical Group, Inc — Billing Profile & Reimbursement Data

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Hartford Healthcare 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