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.

Mhs Primary Care Inc (NPI 1093138935)

Mhs Primary Care Inc is a urgent care clinic/center provider located in Old Saybrook, Connecticut. This profile covers 0 Medicare and 13 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	Mhs Primary Care Inc
Address	154 Main St
City	Old Saybrook
State	CT
ZIP	06475
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	January 29, 2014

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

13 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…	19,140	$40	$669.9K
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…	4,250	$60	$267.7K
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…	2,050	$70	$133.3K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,970	$20	$45.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,990	$10	$23.9K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1,720	$10	$13.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,020	$10	$8.2K
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,…	270	$20	$4.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	30	$60	$1.6K
99442	N/A	40	$30	$1.3K

Showing 1–10 of 13

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

Mhs Primary Care Inc — 0 of 11 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	320	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…	95	130	600	$30	$329.2K
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…	116	1,710	750	$30	$243.3K
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…	68	480	200	$60	$112.1K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	22	90	380	$30	$100.9K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	143	180	120	$40	$40.1K
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,…	266	580	230	$20	$32.8K
99442	N/A	165	220	170	$10	$25.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	21	170	180	$10	$25.3K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	69	230	300	$10	$14.3K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mhs Primary Care, Inc	CT	Family Medicine Physician	$0	$5.4M
Paul Fortgang	CT	Otolaryngology Physician	$94.5K	$98.3K
Richard Frink	CT	Urology Physician	$138.7K	$0
Ronald Hirokawa	CT	Otolaryngology Physician	$86K	$41.3K
Howard Boey	CT	Otolaryngology Physician	$90.3K	$32.9K
Meredith Lindner	CT	Internal Medicine Physician	$123K	$0
Edward Myer	CT	Urology Physician	$112.9K	$0
Nazmiye Hatiboglu	CT	Family Medicine Physician	$107.2K	$0
Elin Christensen	CT	Internal Medicine Physician	$97.1K	$0
Timothy Siegrist	CT	Urology Physician	$94.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robert Edmonstone	CT	Pediatric Dentistry	$0	$1.1M
Old Saybrook Ambulance Assn Inc.	CT	Land Ambulance	$179.2K	$417.5K
Bart Muhs	CT	Vascular Surgery Physician	$572.7K	$0
Neil Becker	CT	Clinical Social Worker	$58.7K	$280.8K
Jennifer Gray	CT	Dermatology Physician	$153.5K	$0
Michelle Higginson	CT	Specialist	$147.5K	$0
John Carroll	CT	Foot Surgery Podiatrist	$106.6K	$0
Oleh Kusen	CT	Psychiatric/Mental Health Nurse Practitioner	$105.2K	$0
Callie Lamay	CT	Podiatrist	$92.4K	$0
Suzanne Tingley	CT	Family Medicine Physician	$88.7K	$0

Mhs Primary Care Inc — Billing Profile & Reimbursement Data

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Mhs Primary Care 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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