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.

Yale University (NPI 1205822236)

Key Findings

Field	Value
Entity Type	Organization
Organization	Yale University
Address	50 Division St
City	New Haven
State	CT
ZIP	06511
Taxonomy	Anesthesiology Physician
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$137.3M
Medicare	$0

YALE UNIVERSITY reports no Medicare billing on file and instead shows an exclusively Medicaid-facing revenue profile with total Medicaid revenue of $137.3M. The absence of Medicare activity makes this provider effectively single‑payer in available federal claims data, which has direct implications for network negotiations and risk exposure tied to state Medicaid policy changes.

Revenue concentration is high: the precomputed top-three Medicaid codes account for 50.3% of the provider’s total Medicaid revenue. Individually, 99214 generated $20.3M revenue (20.7% of this provider's total Medicaid revenue), 99284 generated $18.3M revenue (18.6%), and 99213 generated $10.9M revenue (11.1%), showing that office/outpatient E/M and emergency department E/M dominate receipts.

The code mix (high volume for 99214, 99213, 99284, 99285 and multiple inpatient E/M codes such as 99231–99233) signals a large, acute-care clinical operation with substantial outpatient, emergency department, and inpatient services. Ancillary and specialty procedures are also significant — imaging (74177, 70450, 70553), pathology (88305), echocardiography (93306), and anesthesia (00170) appear in the top code list, consistent with a broad hospital-based service footprint rather than a narrow ambulatory clinic.

YALE UNIVERSITY is a statewide dominant provider for many high-revenue codes: 99284 ranks #1 of 127 providers in-state (100th percentile) and is reported as an extreme outlier, 99214 ranks #2 of 1589 (100th percentile; extreme outlier), and numerous imaging and diagnostic codes (e.g., 74177, 70450, 70553, 93306, 93010) rank #1 in-state and are described as extreme outliers. These rank and percentile signals indicate the provider is a major volume leader across multiple service lines versus in-state peers.

Several codes are documented as statistical outliers in-state, and that status is concentrated among core revenue drivers: codes labeled as extreme outliers (for example 99214, 99284, 99213, 99285, 99244, 74177, 70553) reflect volumes far above typical state patterns, while others are described as notably above typical volume (e.g., 99283, 88305, 99233). This pattern — many top codes flagged as extreme outliers — reinforces the provider’s unusually large scale of Medicaid activity compared with other Connecticut providers.

The presence of high-value specialty codes beyond E/M (e.g., 77387 radiation guidance at $963.8K, 00170 anesthesia at $1.1M, and 88305 pathology at $2.6M) suggests integrated inpatient and specialty procedural capacity that contributes materially to Medicaid revenue. These non-E/M lines diversify revenue sources within Medicaid even as E/M codes dominate the top shares.

Operationally, the mix of very high ED visit volumes (99284, 99285, 99283) together with high levels of subsequent inpatient care (99231–99233) and critical care (99291) implies continuous acute care throughput; this has implications for staffing, bed utilization, and ED-to-inpatient capacity planning tied to Medicaid demand. Payers and competitors should interpret these codes as indicators of heavy acute-care caseflow rather than a primarily elective or outpatient-only practice.

The provider’s NPI was enumerated on 2005-09-26 (~21 years ago), indicating a long-established billing presence in the data. That tenure, combined with the concentrated Medicaid revenue and statewide volume leadership across many top codes, positions YALE UNIVERSITY as a long-standing, high-volume Medicaid provider whose financial and operational performance will be particularly sensitive to Connecticut Medicaid policy and reimbursement changes.

Medicaid: Complete Services Breakdown

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

504 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…	398,830	$50	$20.3M
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.	315,840	$60	$18.3M
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…	320,230	$30	$10.9M
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.	123,940	$70	$9.2M
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…	55,050	$80	$4.4M
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…	132,890	$30	$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.	94,950	$30	$2.9M
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	24,350	$120	$2.9M
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.	69,250	$40	$2.8M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	66,350	$40	$2.6M

Showing 1–10 of 504

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

Yale University — 24 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

504 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.	2	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.	1	130	690	$180	$4.7M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	4	10	760	$3,080	$4.4M
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.	8	110	1,520	$140	$3.4M
J0178	Injection, aflibercept, 1 mg	17	20	1,420	$570	$2.4M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	4	10	1,810	$690	$1.2M
J0585	Injection, onabotulinumtoxina, 1 unit	10	20	1,530	$380	$1M
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	6	10	240	$2,190	$1M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	10	590	$240	$989.9K
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.	1	70	4,950	$110	$980.4K

Showing 1–10 of 504

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yale University	CT	Clinical Medical Laboratory	$1.4M	$10.4M
Robert Schoen	CT	Rheumatology Physician	$1.3M	$0
Yale University	CT	Clinical Medical Laboratory	$946.4K	$390
Sarah Thomen	CT	Family Nurse Practitioner	$848.2K	$0
Wei Jie Zhang	CT	Anesthesiology Physician	$496.9K	$7.6K
Sean Christensen	CT	Dermatology Physician	$441.8K	$0
Alison Hayward	RI	Emergency Medicine Physician	$22.2K	$398.7K
Elise Carlson	CT	Rheumatology Physician	$419.9K	$0
Christine Arms	CT	Diagnostic Radiology Physician	$398.3K	$730
Kathleen Suozzi	CT	Dermatology Physician	$288.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planned Parenthood Of Southern New England, Inc.	CT	Ambulatory Family Planning Facility	$0	$37.9M
Yale New Haven Health At Home, Inc.	CT	Home Health Agency	$0	$17M
Yale-new Haven Hospital	CT	Pediatric Dentistry	$0	$13.7M
Apt Foundation Inc	CT	Methadone Clinic	$1.2M	$11.6M
Clifford W. Beers Guidance Clinic Inc	CT	Adolescent and Children Mental Health Clinic/Center	$0	$11.6M
Chemical Abuse Services Agency, Inc.	CT	Community/Behavioral Health Agency	$162.8K	$10.6M
New Era Rehabilitation Center, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.7M
Sanjay Aggarwal	CT	Internal Medicine Physician	$0	$4.5M
Kristi Rossomando	CT	General Practice Dentistry	$0	$4M
Precipio Inc	CT	Clinical Medical Laboratory	$3.3M	$291.5K

Yale University — 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