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.

Wheeler Clinic Inc (NPI 1396750840)

Field	Value
Entity Type	Organization
Organization	Wheeler Clinic Inc
Address	91 Northwest Drive
City	Plainville
State	CT
ZIP	06062
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	July 30, 2006

Payer Source	Total Paid
Medicaid	$102.6M
Medicare	$0

Key Findings

WHEELER CLINIC INC is effectively a Medicaid-focused provider with $102.6M in lifetime Medicaid revenue and no Medicare billing on file; this makes the organization functionally single‑payer in the datasets supplied and indicates its financial footprint is concentrated entirely in state Medicaid programs. The absence of Medicare revenue means analysts should treat all utilization and competitive comparisons on a Medicaid basis.

Revenue is highly concentrated: the precomputed top three Medicaid codes (T1015, H2019, T1017) account for 91.6% of this provider’s total Medicaid revenue. In particular, T1015 generates $82.7M (80.6%), H2019 generates $9.3M (9.1%), and T1017 generates $2M (1.9%), so the organization’s fiscal performance is overwhelmingly driven by the all‑inclusive clinic visit code T1015.

The code mix and volumes point to a high‑throughput outpatient behavioral health model. T1015 shows 578.5K claims at $143 avg paid/claim, consistent with a clinic visit/encounter, while H2019 (60.3K claims) and T1017 (33.1K claims) reflect therapeutic behavioral services and targeted case management operations; together these codes suggest WHEELER operates as a community mental health clinic delivering bundled clinic encounters, intensive behavioral therapies, and case management.

Competitive standing in Connecticut is strong for its primary service lines: T1015 ranks #5 of 73 providers (94th percentile) and H2019 ranks #2 of 24 (96th percentile), both labeled as typical but high-volume relative to peers, while T1017 ranks #2 of 22 (95th percentile) and is noted as notably above typical state volume. These rank/percentile positions indicate WHEELER is a major state player for clinic visits, behavioral services, and case management compared with in‑state peers.

WHEELER reports extreme outlier volumes on multiple psychotherapy and evaluation codes, signaling unusually large scale in clinical assessment and therapy delivery. Examples include 90791 at 39.3K claims ($35 avg) ranking #1 of 559 providers (100th percentile, extreme outlier), 90847 at 29.3K claims ranking #1 of 150 (100th percentile, extreme outlier), and 90832/90834/90837 also in the top percentiles; collectively these patterns show the organization bills far more psychiatric evaluations and psychotherapy sessions than typical Connecticut providers.

The provider maintains a continuum of crisis and higher‑intensity services alongside routine clinic visits: S9485 crisis intervention per diem appears at 9.7K claims and $1.5M revenue (1.5%), ranking #1 of 7 providers (100th percentile, notably above typical), H2012 behavioral health day treatment appears at 20.9K claims and $1.5M (1.4%), and H0015 intensive outpatient substance use shows 36.6K claims and $584.9K. This indicates capacity for crisis response and both day‑treatment and intensive outpatient programs in addition to routine clinic encounters.

The reimbursement profile shows a reliance on a high unit‑price, high‑volume clinic encounter (T1015 at $143 avg paid/claim) alongside very large claim volumes for low per‑claim psychotherapy services (for example, 90832 at $4 avg paid/claim and 90853 at $4 avg paid/claim). Operationally, that mix implies the organization’s revenue is driven by bundled clinic encounters while staffing and productivity metrics will be strongly influenced by the high volume of low‑unit psychotherapy and group sessions.

WHEELER’s NPI was enumerated on 2006-07-30 (~20 years ago), reflecting long tenure in the market; combined with the provider’s high ranks and extreme outlier status on many behavioral‑health codes, this longevity is consistent with an established, large-scale community mental health operation with deep Medicaid relationships in Connecticut.

Medicaid: Complete Services Breakdown

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

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	578,480	$140	$82.7M
H2019	Therapeutic behavioral services, per 15 minutes	60,310	$150	$9.3M
T1017	Targeted case management, each 15 minutes	33,140	$60	$2M
S9485	Crisis intervention mental health services, per diem	9,710	$150	$1.5M
H2012	Behavioral health day treatment, per hour	20,860	$70	$1.5M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	39,270	$40	$1.4M
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	29,290	$30	$732.4K
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…	165,220	$1	$660.9K
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…	58,530	$10	$643.8K
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	36,560	$20	$584.9K

Showing 1–10 of 84

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

Wheeler Clinic Inc — 13 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

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	5	70	830	$150	$24M
H2019	Therapeutic behavioral services, per 15 minutes	2	20	10,120	$220	$4.8M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	5	70	3,710	$120	$1.6M
S9480	Intensive outpatient psychiatric services, per diem	31	60	5,640	$110	$1.3M
H2012	Behavioral health day treatment, per hour	4	10	10,180	$70	$1.1M
T1017	Targeted case management, each 15 minutes	2	20	4,860	$100	$965.6K
S9485	Crisis intervention mental health services, per diem	1	10	4,210	$160	$619.2K
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…	348	350	1,820	$40	$537.3K
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…	81	1,590	740	$50	$331.8K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	15	30	2,590	$60	$278.5K

Showing 1–10 of 84

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mary Colburn	CT	Family Nurse Practitioner	$35.8K	$0
Pamela Carrington-tribble	CT	Family Medicine Physician	$16.8K	$0
William Brennan	CT	Clinical Social Worker	$4.1K	$0

Nearby Providers

Other providers in the same ZIP code as Wheeler Clinic Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lance Kiss	CT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.5M
Clear Horizon Eyecare, LLC	CT	Optometrist	$0	$1.2M
Central Connecticut Endoscopy Center	CT	Endoscopy Clinic/Center	$341.2K	$347.4K
Robert Carangelo	CT	Orthopaedic Surgery Physician	$252.1K	$0
Bennett Moehl	CT	Clinical Psychologist	$106K	$0
Derrick Bailey	CT	Internal Medicine Physician	$93K	$0
Donald Higgins	CT	Optometrist	$63K	$0
Wendy Rowland	CT	Physician Assistant	$39.6K	$0
Robert Waskowitz	CT	Sports Medicine (Orthopaedic Surgery) Physician	$33.7K	$0
Monika Kieltyka	CT	Family Nurse Practitioner	$29.4K	$0

Wheeler Clinic Inc — Billing Profile & Reimbursement Data

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Wheeler Clinic Inc — 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