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.

Midstate Medical Center (NPI 1154425288)

Midstate Medical Center is a general acute care hospital provider located in Meriden, 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	Midstate Medical Center
Address	435 Lewis Ave
City	Meriden
State	CT
ZIP	06451
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 11, 2006

Payer Source	Total Paid
Medicaid	$1.3M
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
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…	19,100	$20	$458.3K
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…	5,770	$50	$299.9K
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…	15,060	$20	$256K
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…	6,870	$30	$192.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,010	$40	$43.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	630	$20	$10.7K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	140	$60	$8.7K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	130	$40	$4.6K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	20	$140	$2.3K
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…	190	$10	$2.2K

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

Midstate Medical Center — 0 of 13 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
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…	69	80	790	$240	$650K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	57	70	760	$100	$252.3K
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…	18	170	260	$20	$183.2K
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…	9	100	340	$30	$172.2K
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…	8	50	910	$30	$118.4K
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…	36	60	290	$10	$107K
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…	6	90	130	$60	$89.5K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	14	20	50	$150	$44.7K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21	80	180	$40	$41.6K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	19	60	130	$30	$40.6K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midstate Medical Center	CT	General Acute Care Hospital	$0	$110.8M
John Granquist	CT	Cardiovascular Disease Physician	$218.7K	$0
David Altszuler	CT	Cardiovascular Disease Physician	$195.7K	$0
Kevin Tally	CT	Cardiovascular Disease Physician	$193.3K	$0
John Mccallum	CT	Orthopaedic Surgery Physician	$182.9K	$0
George Spivack	CT	Cardiovascular Disease Physician	$179.2K	$0
Maximilian Lee	CT	Cardiovascular Disease Physician	$172.3K	$0
Andrew Feingold	CT	Cardiovascular Disease Physician	$164.8K	$0
Steven Bleich	CT	Cardiovascular Disease Physician	$163.2K	$0
John Dinkler	CT	Cardiovascular Disease Physician	$163K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hunter's Ambulance Service, Inc.	CT	Ambulance	$4.2M	$25.5M
Emergency Medicine Physicians Of New Haven County,llc	CT	Emergency Medicine Physician	$0	$8.6M
Midstate Gastroenterology Specialists PC	CT	Gastroenterology Physician	$0	$6.6M
Midstate Radiology Associates, LLC	CT	Diagnostic Radiology Physician	$0	$6.6M
Nems PLLC	CT	Emergency Medicine Physician	$0	$6.1M
B.e.k Eyecare, Inc	CT	Optometrist	$0	$3.7M
Apple Dental And Associates,llc	CT	General Practice Dentistry	$0	$2.1M
Connecticut Counseling Centers, Inc	CT	Methadone Clinic	$0	$2M
Franciscan Family Care Center, Inc.	CT	Home Health Agency	$0	$1.8M
Sph Meriden LLC	CT	General Practice Dentistry	$0	$1.1M

Midstate Medical Center — Billing Profile & Reimbursement Data

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Midstate Medical Center — 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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