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.

Back To Health Of Branford, LLC (NPI 1215958772)

Back To Health Of Branford, LLC is a internal medicine physician provider located in Branford, Connecticut. This profile covers 0 Medicare and 16 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	Back To Health Of Branford, LLC
Address	400 West Main Street
City	Branford
State	CT
ZIP	06405
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 21, 2006

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

16 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…	13,250	$60	$742.1K
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…	14,390	$40	$532.5K
99443	N/A	6,520	$30	$208.7K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	21,990	$1	$22K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	160	$90	$15.4K
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…	180	$90	$15.4K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	240	$30	$7.2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	70	$100	$6.7K
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…	30	$100	$3.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	370	$10	$2.9K

Showing 1–10 of 16

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

Back To Health Of Branford, LLC — 2 of 16 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

16 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…	130	1,590	740	$50	$331.8K
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…	146	1,710	750	$30	$243.3K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	330	440	1,200	$30	$118.2K
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…	367	480	150	$90	$100.9K
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…	211	380	220	$70	$99.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	116	200	530	$20	$69.3K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	18	30	440	$30	$44.9K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	144	150	190	$50	$43.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	83	140	150	$60	$38.6K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	54	90	260	$30	$31.4K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sema4 Opco, Inc	CT	Clinical Medical Laboratory	$0	$10.8M
Hhc Physician Services, PLLC	CT	Internal Medicine Physician	$0	$7.7M
Physicians Alliance Of Connecticut, LLC	CT	Internal Medicine Physician	$0	$6.3M
Genco Lab LLC	CT	Clinical Medical Laboratory	$648.4K	$2.6M
Branford Pediatrics & Allergy, P.C.	CT	Allergy Physician	$0	$3.1M
Town Of Branford	CT	Land Ambulance	$542.1K	$1.7M
Prime Dental LLC	CT	General Practice Dentistry	$0	$1.7M
Town Of Branford	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.7M
New Horizon Healthcare, LLC	CT	Physician Assistant	$0	$1.4M
Stony Creek Urgent Care Center, LLC	CT	General Practice Physician	$0	$1.2M

Back To Health Of Branford, LLC — Billing Profile & Reimbursement Data

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Back To Health Of Branford, LLC — 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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References