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.

Hartford Hospital (NPI 1407806391)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hartford Hospital
Address	80 Seymour St
City	Hartford
State	CT
ZIP	06102
Taxonomy	Surgery Physician
NPI Enumerated	May 11, 2006

Payer Source	Total Paid
Medicaid	$27.5M
Medicare	$0

HARTFORD HOSPITAL (HARTFORD, CT) is effectively a Medicaid-centered operation: the provider shows $27.5M in total Medicaid revenue on file and has no Medicare billing on file, making it functionally single-payer in the available claims data. Its NPI was enumerated on 2006-05-11 (~20 years ago), indicating long-tenured participation in public programs.

Revenue is concentrated in a small set of high-volume emergency and inpatient E/M codes: the precomputed top three Medicaid codes (99285, 99284, 99232) account for 54.5% of the provider’s total Medicaid revenue. Those three codes individually report 99285: 90.3K claims, $71 avg paid/claim, $6.4M revenue (24.5%); 99284: 106.2K claims, $53 avg paid/claim, $5.6M revenue (21.5%); and 99232: 92.2K claims, $24 avg paid/claim, $2.2M revenue (8.5%).

The code mix points to a high-volume emergency department and significant inpatient follow-up care as the core service lines: 99285 and 99284 (high- and moderate-acuity ED E/M) drive nearly half of Medicaid revenue between them, while 99232 (subsequent inpatient/observation care) is the third-largest revenue contributor. High counts for ED codes paired with substantial inpatient E/M suggest an integrated acute-care hospital workflow with heavy ED-to-inpatient throughput.

HARTFORD HOSPITAL shows outsized critical care and short-term inpatient activity relative to peers: 99291 (critical care) records 25.9K claims, $74 avg paid/claim, $1.9M revenue (7.3%) and ranks #1 of 80 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). Likewise, 99231 (subsequent inpatient visit) posts 76.7K claims, $15 avg paid/claim, $1.2M revenue (4.4%) and ranks #1 of 62 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code), reinforcing the provider’s role as a regional center for high-acuity inpatient care.

Emergency department volume is a clear strength: 99285 (90.3K claims, $6.4M revenue, 24.5%) ranks #6 of 129 providers in-state (96th percentile; notably above typical state volume), and 99284 (106.2K claims, $5.6M revenue, 21.5%) ranks #7 of 127 providers in-state (95th percentile; notably above typical state volume). The combination of very high claim counts and top-decile rankings indicates the hospital is a major ED destination within Connecticut.

Beyond ED and inpatient E/M, the hospital has sizable behavioral health and obstetric imaging activity that diversifies its Medicaid revenue base: 90791 (psychiatric evaluation) shows 20K claims, $36 avg paid/claim, $720.6K revenue (2.8%) and ranks #4 of 559 providers in-state (99th percentile; extreme outlier, far above typical state volume), while fetal monitoring and ultrasound codes such as 59025 (17.7K claims, $672K revenue, 2.6%) and 76815 (6.8K claims, $170.3K revenue, 0.7%) appear with notable volumes. These additional lines point to multi-service hospital operations including perinatal and mental-health services.

Competitive standing within Connecticut is strong: the provider is top-ranked (rank #1, 100th percentile) on multiple high-acuity inpatient and critical-care codes (e.g., 99291, 99231, 99292, 99252), and appears in high percentiles (95th–99th) on many other core E/M codes. Those rank positions and percentile signals characterize HARTFORD HOSPITAL as a dominant regional acute-care provider for several Medicaid services, not merely a modest participant.

From a payer and contracting perspective, the combination of reliance on Medicaid ($27.5M, no Medicare revenue on file) and revenue concentration (top 3 codes = 54.5% of Medicaid revenue) creates specific negotiation and risk considerations: payers should note the hospital’s dependence on high-volume ED and inpatient E/M services when modeling utilization, reimbursement, and potential network impact. The provider’s long tenure (NPI enumerated 2006-05-11, ~20 years) and leadership on multiple high-acuity codes further support its role as a stable, high-capacity acute care partner in-state.

Medicaid: Complete Services Breakdown

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

138 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.	90,320	$70	$6.4M
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.	106,240	$50	$5.6M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	92,150	$20	$2.2M
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…	25,930	$70	$1.9M
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…	71,630	$20	$1.6M
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…	64,550	$20	$1.5M
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.	52,540	$30	$1.5M
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	76,730	$20	$1.2M
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20,020	$40	$720.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	17,680	$40	$672K

Showing 1–10 of 138

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

Hartford Hospital — 11 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

138 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	6	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.	7	130	690	$180	$4.7M
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.	21	110	1,520	$140	$3.4M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	38	60	3,070	$100	$907.8K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	25	50	870	$510	$687.2K
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…	1	80	790	$240	$650K
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…	6	100	1,120	$120	$564.2K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	5	50	1,820	$100	$515.7K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	15	30	1,560	$160	$444.1K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	27	60	560	$380	$437.2K

Showing 1–10 of 138

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hartford Hospital	CT	General Acute Care Hospital	$0	$316.3M
The Hospital Of Central Connecticut At New Britain General And Bradley	CT	General Acute Care Hospital	$0	$220M
Windham Community Memorial Hospital, Inc.	CT	General Acute Care Hospital	$0	$69.5M
Hartford Healthcare Medical Group Specialists, PLLC	CT	Surgery Physician	$0	$46M
Hartford Healthcare Medical Group, Inc	CT	Surgery Physician	$0	$22.4M
The Hospital Of Central Connecticut At New Britain General And Bradley	CT	Hospitalist Physician	$0	$22.2M
Philip Simkovitz	CT	Critical Care Medicine (Internal Medicine) Physician	$589.2K	$506K
Pouyan Changizzadeh	CT	Hematology & Oncology Physician	$1.1M	$0
Edward Fitzpatrick	CT	Ophthalmology Physician	$757.6K	$0
Nikia Bray	CT	Family Nurse Practitioner	$58.9K	$557K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jefferson Radiology, PC	CT	Diagnostic Radiology Physician	$0	$14M
Hartford Pathology Associates, P.C.	CT	Anatomic Pathology & Clinical Pathology Physician	$0	$4.5M
Anshu Trivedi	CT	Anatomic Pathology Physician	$296.6K	$0
Vinay Gulati	CT	Nuclear Cardiology Physician	$238.9K	$0
Kelsey Burger	CT	Medical Physician Assistant	$153.1K	$0
Robert Dowsett	CT	Radiation Oncology Physician	$150.1K	$0
Susan Kim	CT	Radiation Oncology Physician	$148.4K	$0
Hhc Hartford Surgery Center, LLC	CT	Ambulatory Surgical Clinic/Center	$126.4K	$0
Dana Boe	CT	Diagnostic Radiology Physician	$120K	$0
Mahesh Patel	CT	Internal Medicine Physician	$119.3K	$0

Hartford 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