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.

Fairfield County Healthcare Associates (NPI 1235212036)

Fairfield County Healthcare Associates is a pediatrics physician provider located in Trumbull, Connecticut. This profile covers 0 Medicare and 59 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	Fairfield County Healthcare Associates
Address	6600 Main Street
City	Trumbull
State	CT
ZIP	06611
Taxonomy	Pediatrics Physician
NPI Enumerated	October 23, 2006

Payer Source	Total Paid
Medicaid	$16.5M
Medicare	$0

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

59 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…	90,350	$80	$6.8M
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…	19,850	$110	$2.1M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	38,980	$50	$1.8M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	7,700	$120	$954.6K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	19,660	$50	$884.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	5,850	$120	$719.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	6,390	$110	$709.2K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	16,970	$20	$339.3K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	11,590	$30	$324.4K
99174	The provider uses instruments to conduct a vision screening exam on both eyes. The procedure includes analysis and report.	14,660	$20	$263.8K

Showing 1–10 of 59

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

Fairfield County Healthcare Associates — 6 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

59 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…	95	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…	29	1,710	750	$30	$243.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12	170	850	$80	$203.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	15	160	680	$70	$166.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	8	140	780	$40	$163.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	9	240	1,560	$20	$159.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	15	180	710	$70	$151.2K
99417	The provider spends additional time on an outpatient evaluation and management service. Use this code for each additional 15 minutes beyond the minimum required time.	21	20	480	$130	$142.1K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	20	20	300	$190	$134.9K
83718	The lab analyst performs a test to directly measure the high density lipoprotein, HDL, cholesterol in a patient specimen.	12	20	3,380	$10	$112.1K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coordinated Transportation Solutions, Inc.	CT	Transportation Broker	$0	$94.1M
Progressive Diagnostics, LLC	CT	Clinical Medical Laboratory	$222.3K	$6M
Childrens Dentistry Of Trumbull, PC	CT	Pediatric Dentistry	$0	$4M
Nephrology Associates, PC	CT	Nephrology Physician	$0	$2.4M
Trumbull Pediatrics PC	CT	General Practice Physician	$0	$1.7M
Town Of Trumbull	CT	Ambulance	$494.9K	$1.1M
Trumbull Public Schools	CT	Local Education Agency (LEA)	$0	$1.4M
Raphael Capasso	CT	Optometrist	$0	$1.2M
Connecticut In Home Assistance LLC	CT	Chore Provider	$0	$1.1M
Philip Simkovitz	CT	Critical Care Medicine (Internal Medicine) Physician	$589.2K	$506K

Fairfield County Healthcare Associates — Billing Profile & Reimbursement Data

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Fairfield County Healthcare Associates — 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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