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.

Shoreline Wellness Behavioral Health Clinic, LLC (NPI 1316347933)

Shoreline Wellness Behavioral Health Clinic, LLC is a community/behavioral health agency provider located in West Haven, Connecticut. This profile covers 0 Medicare and 11 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	Shoreline Wellness Behavioral Health Clinic, LLC
Address	415 Main St
City	West Haven
State	CT
ZIP	06516
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	September 2, 2014

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	19,820	$100	$2M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	6,380	$70	$421.2K
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…	2,290	$100	$233.1K
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…	720	$130	$91.9K
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…	760	$70	$54.6K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	190	$110	$21.7K
99442	N/A	250	$70	$18.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	220	$50	$11.3K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	190	$60	$10.5K
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	170	$50	$8.7K

Showing 1–10 of 11

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

Shoreline Wellness Behavioral Health Clinic, LLC — 1 of 11 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

11 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…	501	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…	855	1,710	750	$30	$243.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	27	2,180	850	$90	$202.1K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	281	420	1,230	$20	$199.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	79	570	410	$50	$197.6K
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…	413	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…	103	380	220	$70	$99.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	193	560	80	$80	$90.3K
99442	N/A	91	220	170	$10	$25.9K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	61	140	160	$20	$12.2K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Apt Foundation Inc.	CT	Methadone Clinic	$0	$21.6M
West Haven Board Of Education	CT	Local Education Agency (LEA)	$0	$6.3M
Haven Pediatric Dentistry,llc	CT	Pediatric Dentistry	$0	$5.6M
Livwell Pain Management LLC	CT	Family Nurse Practitioner	$0	$3.9M
West Haven Pediatrics, LLC	CT	Pediatrics Physician	$0	$3.5M
Pediatric Advanced Care Of West Haven LLC	CT	Pediatric Nurse Practitioner	$0	$2.4M
True Pediatric Dental Care LLC	CT	Pediatric Dentistry	$0	$2M
Elvin Griffith, M.d. P.C.	CT	Internal Medicine Physician	$0	$1.7M
Elm Family Dental Associates LLC	CT	General Practice Dentistry	$0	$1.3M
Stephanie Smerglinolo	CT	Family Nurse Practitioner	$195.5K	$0

Shoreline Wellness Behavioral Health Clinic, LLC — Billing Profile & Reimbursement Data

Sign up for Shoreline Wellness Behavioral Health Clinic, LLC — Billing Profile & Reimbursement Data policy alerts

Shoreline Wellness Behavioral Health Clinic, LLC — Billing Profile & Reimbursement Data

Sign up for Shoreline Wellness Behavioral Health Clinic, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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