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.

The Griffin Hospital (NPI 1184639973)

Key Findings

Field	Value
Entity Type	Organization
Organization	The Griffin Hospital
Address	130 Division St
City	Derby
State	CT
ZIP	06418
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 30, 2006

Payer Source	Total Paid
Medicaid	$80.7M
Medicare	$0

THE GRIFFIN HOSPITAL is effectively a single‑payer Medicaid hospital in the dataset: it has no Medicare billing on file while reporting $80.7M in lifetime Medicaid revenue. This suggests the provider’s recorded business activity in our claims universe is dominated by Medicaid-covered services rather than fee‑for‑service Medicare, which will materially shape payer mix, contracting leverage, and risk attribution analyses.

Revenue is heavily concentrated in emergency department evaluation and management services: the precomputed top‑3 Medicaid codes together account for 55.0% of the provider’s total Medicaid revenue, and those top codes are 99284, 99285, and 99283. This concentration indicates that ED visits (spanning low, moderate, and high medical decision making) are the primary revenue driver for the hospital’s Medicaid business, implying the hospital operates with a high volume ED that captures a majority of outpatient Medicaid payments.

Despite the ED concentration, THE GRIFFIN HOSPITAL does not appear to be a statewide leader on those ED codes; 99284 ranks #31 of 127 providers in-state (76th percentile), 99285 ranks #32 of 129 (76th percentile), and 99283 ranks #31 of 114 (73th percentile). Those percentiles describe modest to above‑median share — consistent with a busy, service‑intensive community hospital but not a dominant statewide center for emergency visits.

THE GRIFFIN HOSPITAL shows notable volume in high‑throughput SARS‑CoV‑2 testing: U0003 has 130.8K claims, $24 avg paid/claim, $3.1M revenue and ranks #2 of 46 providers in-state (98th percentile), labeled "notably above typical" for state volume. A similarly elevated position for U0005 (64.4K claims, $11 avg paid/claim, $708K revenue; rank #3 of 50, 96th percentile) reinforces that the hospital was a major local hub for COVID PCR testing during the period captured by these claims.

The provider’s code mix includes material ancillary and specialty service lines beyond the ED: significant volumes and revenues appear for physical therapy (97110: 57.5K claims, $2.8M; 95th percentile), diagnostic imaging and CT (74177, 74176, 70450), endoscopy and colonoscopy (43239, 45380), and sleep studies (95810, 95811). These patterns indicate a broad outpatient hospital footprint offering rehabilitation, imaging, GI, and sleep medicine services to Medicaid patients in addition to emergency care.

There is a measurable outpatient infusion and medication administration footprint. Intravenous administration codes 96374, 96375, and 96365 together represent recurring Medicaid revenue (96374: 25K claims, $3.2M revenue; 96375 and 96365 also listed), and J9312 (rituximab, 10 mg) appears with a high avg paid/claim ($4285) but limited claims (138) and $591.3K revenue, ranking #3 of 3 providers in-state. This combination points to an infusion-capable facility that performs frequent low‑cost medication administrations plus occasional high‑cost biologic infusions.

The hospital’s tenure in the NPI registry is long: NPI enumerated (registered) 2006-07-30 (~20 years ago). This long enumeration period supports interpreting the observed code mix as the result of an established community hospital rather than a newly opened facility or a recent change in operations. Combined with the service mix and rank percentiles, the picture is of a stable, community acute care hospital with a high‑volume ED and substantial outpatient ancillary services under Medicaid.

Medicaid: Complete Services Breakdown

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

482 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	36,980	$390	$14.5M
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.	22,890	$490	$11.3M
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.	38,410	$210	$8.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	25,040	$130	$3.2M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	130,810	$20	$3.1M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	57,510	$50	$2.8M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	7,070	$210	$1.5M
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.	2,750	$500	$1.4M
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,…	1,690	$800	$1.4M
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…	1,850	$680	$1.3M

Showing 1–10 of 482

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

The Griffin Hospital — 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

482 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	19	40	21,520	$90	$8M
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.	32	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.	31	130	690	$180	$4.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	18	40	23,540	$140	$3.7M
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.	31	110	1,520	$140	$3.4M
J9312	Injection, rituximab, 10 mg	3	10	240	$3,030	$3.2M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	21	70	3,710	$120	$1.6M
S9480	Intensive outpatient psychiatric services, per diem	20	60	5,640	$110	$1.3M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	25	30	17,770	$50	$1.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	23	40	1,910	$190	$1.1M

Showing 1–10 of 482

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gangadhara Kabbli	NY	Cardiovascular Disease Physician	$117.7K	$31.1K
Mihaela Boran	CT	Psychiatry Physician	$26.4K	$0
Maria Dawe	CT	Psychiatry Physician	$21.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Griffin Faculty Physicians, Inc.	CT	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$0	$11.2M
Connecticut Post Acute Medical Services 1 PC	CT	Hospitalist Physician	$0	$5.1M
Medexpress Urgent Care Connecticut, P.C.	CT	Urgent Care Clinic/Center	$0	$4.3M
Neelima Kaushal, LLC	CT	Obstetrics & Gynecology Physician	$0	$2.1M
Lower Naugatuck Valley Parent Child Resource Center, Inc.	CT	Mental Health Counselor	$0	$1.9M
Derby Public Schools	CT	Local Education Agency (LEA)	$0	$1.8M
Dr.dental Of Derby P.C.	CT	General Practice Dentistry	$0	$1M
Carlos Schweitzer	CT	Internal Medicine Physician	$111.7K	$379.4K
Mark Thimineur	CT	Interventional Pain Medicine Physician	$454.4K	$0
Kenneth Spector	CT	Interventional Cardiology Physician	$335.3K	$0

The Griffin Hospital — Billing Profile & Reimbursement Data

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The Griffin Hospital — 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