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.

Norwalk Hospital Association (NPI 1427041581)

Field	Value
Entity Type	Organization
Organization	Norwalk Hospital Association
Address	34 Maple St
City	Norwalk
State	CT
ZIP	06850
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 24, 2005

Payer Source	Total Paid
Medicaid	$77.5M
Medicare	$0

Key Findings

NORWALK HOSPITAL ASSOCIATION is effectively single-payer in the available dataset: there is no Medicare billing on file while total reported Medicaid revenue is $77.5M. The provider’s NPI was enumerated 2005-08-24 (~21 years ago), indicating long-standing operation in the market but current billing is concentrated in Medicaid.

Revenue concentration is high and dominated by emergency department evaluation-and-management codes: the top 3 Medicaid codes account for 58.6% of this provider's total Medicaid revenue, driven by 99285 (29.6%), 99284 (14.6%), and 99283 (14.4%). This indicates that a majority of the facility’s Medicaid receipts come from ED care across high, moderate, and low acuity levels.

The code-level volume confirms an ED-centric throughput model: 99285 shows 75.1K claims at $255 avg paid/claim ($19.1M revenue), 99284 shows 51.7K claims at $183 avg paid/claim ($9.5M), and 99283 shows 62.3K claims at $150 avg paid/claim ($9.3M). The claim counts and per-claim payments together suggest high-frequency emergency care delivery with meaningful representation of higher-acuity presentations.

Competitive standing within Connecticut is strongest on the highest-acuity ED code: 99285 ranks #12 of 129 providers in-state (91th percentile; notably above typical state volume), which signals a relative regional leadership for high-acuity ED visits. By contrast 99284 ranks #24 of 127 (82th percentile; typical, unremarkable volume) and 99283 ranks #17 of 114 (86th percentile; typical, unremarkable volume), indicating solid but not dominant share for moderate- and low-acuity ED work.

The provider also generates notable Medicaid revenue from GI endoscopy and colonoscopy services, with 43239 ($2.5M, 3.9%) ranking #11 of 83 (88th percentile) and 45380 ($2.3M, 3.6%) ranking #9 of 66 (88th percentile). These placements point to above-typical in-state volume for diagnostic endoscopy/biopsy work and a meaningful outpatient procedural capability beyond ED care.

Infusion and procedure-administration activity complements the ED mix: 96374 reports 25.3K claims and $3.6M revenue (5.6%), and related infusion/IV codes 96361, 96365, 96360, and 96375 together contribute additional Medicaid revenue. Chemotherapy administration (96413, $1.2M, 1.9%) is present but smaller, suggesting infusion services are driven primarily by acute/ED-associated treatments rather than oncology alone.

Imaging and diagnostic testing are also material lines: CT abdomen/pelvis 74177 ($1.6M, 2.5%) and CT head 70450 ($882.7K, 1.4%) show substantial utilization, while multiplex respiratory testing 87637 ($781.8K, 1.2%) ranks #3 of 39 (95th percentile; notably above typical state volume). High placement for 87637 indicates elevated throughput for respiratory pathogen testing relative to peers.

Because Medicaid accounts for the entirety of reported revenue and ED E/M codes make up a majority share (58.6%), the provider’s financial exposure is concentrated in Medicaid reimbursement dynamics and ED volume trends. Analysts assessing contract negotiations or network adequacy should treat ED capacity, infusion throughput, and Medicaid payment policy as the primary drivers of near-term revenue risk and opportunity for this hospital.

Medicaid: Complete Services Breakdown

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

401 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.	75,090	$260	$19.1M
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.	51,720	$180	$9.5M
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.	62,330	$150	$9.3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	25,350	$140	$3.6M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	5,120	$500	$2.5M
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…	3,220	$730	$2.3M
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…	48,690	$40	$2.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	21,520	$80	$1.8M
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.	8,830	$190	$1.6M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	6,080	$210	$1.2M

Showing 1–10 of 401

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

Norwalk Hospital Association — 0 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

401 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	18	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.	12	130	520	$330	$5.9M
J9271	Injection, pembrolizumab, 1 mg	10	10	210	$5,070	$5.8M
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.	24	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.	17	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.	17	110	1,520	$140	$3.4M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8	10	330	$1,810	$3.3M
19318	Breast reduction is the removal of excess breast tissue which results from top scarring, calcification, or architectural distortion.	2	10	280	$5,380	$1.5M
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	105	120	1,930	$180	$1.3M
S9480	Intensive outpatient psychiatric services, per diem	42	60	5,640	$110	$1.3M

Showing 1–10 of 401

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norwalk Hospital Association	CT	Land Ambulance	$0	$1.9M
Steven Berger	MA	Ophthalmology Physician	$392.9K	$25.2K
Duane Dyson	NJ	Emergency Medicine Physician	$244.3K	$6.4K
David Lomnitz	CT	Cardiovascular Disease Physician	$210.7K	$0
Michael Pittaro	CT	Clinical Cardiac Electrophysiology Physician	$209.9K	$0
Boris Sheynberg	CT	Interventional Cardiology Physician	$193.9K	$0
David Lorenz	CT	Interventional Cardiology Physician	$189.4K	$0
Tao-nan Chi	CT	Internal Medicine Physician	$167K	$0
Charles Augenbraun	CT	Cardiovascular Disease Physician	$163.4K	$0
Charles Cochran	CT	Internal Medicine Physician	$150.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
T.l.c. Pediatrics, LLC	CT	Pediatrics Physician	$0	$7.6M
Family & Children's Agency, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.8M
New Vision Cataract Center LLC	CT	Ambulatory Surgical Clinic/Center	$1.1M	$802.1K
Dva Renal Healthcare Inc	CT	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.8M
Granit Veseli	CT	Clinical Cardiac Electrophysiology Physician	$567.3K	$10
Gillian Levy	CT	Anatomic Pathology & Clinical Pathology Physician	$361.3K	$0
Stephen Batter	CT	Specialist	$301K	$0
Richard Culver	CT	Diagnostic Radiology Physician	$268.1K	$0
Scott Serels	CT	Specialist	$267.6K	$0
Steven Berman	CT	Urology Physician	$256.2K	$0

Norwalk Hospital Association — Billing Profile & Reimbursement Data

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Norwalk Hospital Association — 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