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.

Stamford Hospital (NPI 1356331425)

Field	Value
Entity Type	Organization
Organization	Stamford Hospital
Address	1 Hospital Plz
City	Stamford
State	CT
ZIP	06902
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 28, 2005

Payer Source	Total Paid
Medicaid	$139.9M
Medicare	$0

Key Findings

STAMFORD HOSPITAL has no Medicare billing on file and reports $139.9M in lifetime Medicaid revenue, making its visible revenue footprint effectively concentrated in the Medicaid program rather than split across Medicare and Medicaid in the available data. Analysts should treat this provider as a Medicaid-dominant entity for payer-mix analysis given the absence of Medicare claims.

Revenue concentration in Medicaid is heavily driven by emergency department evaluation-and-management services: the precomputed top-3 Medicaid codes account for 45.9% of the provider's total Medicaid revenue, and those three codes are 99285 ($22.5M, 22.6%), 99284 ($12.7M, 12.8%), and 99283 ($10.4M, 10.5%). This indicates that nearly half of Medicaid revenue is tied to high-volume ED activity rather than a broad dispersion across many low-revenue codes.

The code mix suggests an operational profile centered on a high-volume emergency department coupled with substantial outpatient and ancillary services. High revenues for ED E/M codes (99285, 99284, 99283) alongside sizable payments for outpatient clinic visits G0463 ($8M) and therapeutic exercise 97110 ($8.6M) point to integrated acute and outpatient therapy capacity within the hospital.

Although ED codes drive the largest share of Medicaid revenue, the provider's statewide competitive standing on those ED codes is modest-to-typical: 99285 ranks #21 of 129 providers in-state (84th percentile), 99284 ranks #30 of 127 (77th percentile), and 99283 ranks #22 of 114 (81th percentile). These ranks indicate consistent, substantial ED volume but not statewide dominance in emergency visitation relative to peers.

Several specific service lines are extreme outliers in state volume and signal specialized capacity: 97110 is an extreme outlier (143.1K claims, $8.6M revenue; rank #6 of 348, 99th percentile) and 87635 is an extreme outlier (57.9K claims, $1.8M revenue; rank #3 of 140, 99th percentile). These concentrations suggest unusually large physical therapy throughput and high-volume COVID-19 testing/lab activity relative to Connecticut peers.

STAMFORD HOSPITAL shows notable leadership on particular procedures and diagnostic services beyond ED work: 64493 is ranked #1 of 18 in-state (100th percentile) with $1.2M revenue and is described as notably above typical state volume, and 93975 is ranked #2 of 42 (98th percentile) with $1.4M revenue. Such top-state rankings identify discrete procedure lines where the hospital is a go-to provider within Connecticut.

Imaging, endoscopy, and infusion/infusion-related charges form a meaningful portion of Medicaid revenue and indicate broad clinical scope: CT abdomen/pelvis 74177 ($2.8M), CT head 70450 ($1.8M), screening mammography 77067 ($1.9M), colonoscopy 45380 ($2.3M) and 45385 ($1M), esophagogastroduodenoscopy 43239 ($1.3M), and infusion/chemotherapy codes such as 96374 ($4.3M) and 96413 ($1.2M) are all present in the top code list. This mix supports a full-service acute hospital with diagnostic imaging, endoscopy, infusion therapy, and oncology-capable outpatient services on the Medicaid side.

The provider is an established entity with an NPI enumerated 2005-10-28 (~21 years ago), signaling a long-tenured presence in the market; combined with $139.9M Medicaid lifetime revenue and concentrated ED and therapy volumes, the data portray a mature hospital with an entrenched Medicaid patient base and specific service-line strengths that drive the majority of its reported Medicaid receipts.

Medicaid: Complete Services Breakdown

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

598 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	44,130	$510	$22.5M
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.	42,620	$300	$12.7M
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.	49,380	$210	$10.4M
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…	143,070	$60	$8.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	81,590	$100	$8M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	32,140	$140	$4.3M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,330	$1,250	$4.2M
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.	15,110	$180	$2.8M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	11,860	$200	$2.3M
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…	3,260	$710	$2.3M

Showing 1–10 of 598

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

Stamford Hospital — 4 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

598 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1459	Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg	3	10	6,330	$1,000	$8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9	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.	21	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.	30	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.	13	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.	22	110	1,520	$140	$3.4M
44970	Laparoscopy, surgical, appendectomy	3	10	230	$4,770	$1.7M
J2505	Injection, pegfilgrastim, 6 mg	6	10	130	$2,110	$1.2M
G0379	Direct admission of patient for hospital observation care	6	10	680	$1,140	$1.1M
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	9	10	160	$4,170	$1.1M

Showing 1–10 of 598

Related Providers

Other providers that share a Tax Identification Number (TIN) with Stamford Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Glenn Gandelman	CT	Cardiovascular Disease Physician	$1.7M	$593.4K
Francis Walsh	CT	Internal Medicine Physician	$467.6K	$0
Carolyn Testa-casino	CT	Physical Medicine & Rehabilitation Physician	$440.8K	$0
Paul Gagne	MA	Vascular Surgery Physician	$437.9K	$0
Sandhya Dhruvakumar	CT	Clinical Cardiac Electrophysiology Physician	$359.1K	$0
Ketan Badani	NY	Urology Physician	$190.8K	$2K
Michael Sergi	CT	Vascular Surgery Physician	$191.5K	$0
David Lorenz	CT	Interventional Cardiology Physician	$189.4K	$0
Patricia Mcaleer	CT	Specialist	$181.3K	$0
Joseph Tiano	CT	Clinical Cardiac Electrophysiology Physician	$179.2K	$0

Nearby Providers

Other providers in the same ZIP code as Stamford Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stamford Emergency Medical Services, Inc.	CT	Land Ambulance	$1.5M	$6.3M
Mvc Ct	CT	Surgery Physician	$0	$2.7M
Dva Renal Healthcare Inc	CT	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.6M
Yoo Jin Shin	CT	Pediatric Dentistry	$0	$1.7M
Rainbow Pediatrics, LLC	CT	Pediatrics Physician	$0	$1.6M
Emergency Medicine Physicians Of Fairfield County, LLC	CT	Emergency Medicine Physician	$0	$1.6M
South End Dental Center PC	CT	General Practice Dentistry	$0	$1.5M
Child Guidance Center Of Southern Connecticut, Inc.	CT	Community/Behavioral Health Agency	$0	$1.5M
Andrews Adade Md, PC	CT	Pediatric Adolescent Medicine Physician	$0	$1.5M
Stamford Pathology Group PC	CT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.3M

Stamford 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