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.

The William W Backus Hospital (NPI 1467517235)

Field	Value
Entity Type	Organization
Organization	The William W Backus Hospital
Address	326 Washington St
City	Norwich
State	CT
ZIP	06360
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 22, 2006

Payer Source	Total Paid
Medicaid	$163M
Medicare	$0

Key Findings

THE WILLIAM W BACKUS HOSPITAL (NORWICH, CT) is a General Acute Care Hospital with an NPI enumerated 2006-12-22 (~20 years ago), indicating long-standing enrollment in federal programs and an established operational footprint in-state. The provider’s public Medicare billing record shows none on file, so available claims and revenue detail are exclusively from Medicaid sources.

This provider is effectively single‑payer with respect to the available federal billing data: Total Medicare revenue is listed as none while Total Medicaid revenue is $163M, meaning all reportable federal program revenue in our dataset comes from Medicaid. That concentration carries implications for reimbursement exposure and benchmarking because Medicare-level comparisons are not available for this entity.

Revenue is highly concentrated in emergency department evaluation-and-management services: the top 3 Medicaid codes (99285, 99284, 99283) together account for 62.9% of the provider’s total Medicaid revenue. Individually, 99285 generates $35.8M (27.8%), 99284 generates $29.4M (22.8%), and 99283 generates $15.8M (12.3%), signaling that high-, moderate-, and low‑complexity ED visits are the primary revenue drivers.

The ED dominance is further supported by claims volume and statistical standing: 99285 has 119.4K claims and 99284 has 172.8K claims, and these codes rank #3 of 129 (98th percentile, described as an extreme outlier) and #4 of 127 (98th percentile, notably above typical state volume), respectively. Those ranks position Backus as a major statewide provider of emergency services, far above typical in-state peers for these codes.

Infusion and procedure administration activity is also material and complements the ED-focused profile: 96374 accounts for $7.2M (5.6%) with 50.1K claims (rank #7 of 37, 83rd percentile) and related IV/infusion codes such as 96365 ($2.3M, 1.8%) and 96361 ($2.3M, 1.8%) show substantial utilization. This pattern suggests frequent administration of medications and IV therapies in the hospital outpatient or ED setting rather than a sole focus on routine clinic visits.

Outpatient therapy and clinic services are notable secondary lines of business. Code 97110 (therapeutic exercise) contributes $4.8M (3.8%) with 109.9K claims and ranks #10 of 348 in-state (97th percentile, notably above typical state volume), while G0463 (hospital outpatient clinic visit) represents $4.9M (3.8%) with 80.1K claims, indicating meaningful volume in rehab and clinic-based management.

Imaging and specialty diagnostics supply additional, diversified revenue: CT abdomen/pelvis with contrast 74177 contributes $3.5M (2.7%, rank #8 of 72, 90th percentile), 93306 echocardiography contributes $1.5M (1.1%), and CT head 70450 contributes $1.1M (0.8%). These items point to an integrated acute-care capability (ED + imaging + cardiology diagnostics) supporting the hospital’s high ED throughput.

The lack of Medicare billing on file limits national Medicare peer benchmarking and suggests the provider either does not bill Medicare in the available timeframe or that Medicare activity is not present in the dataset; payers and analysts should treat the hospital as Medicaid‑centric for contract, utilization, and network planning. Given the heavy reliance on a small set of ED codes for 62.9% of Medicaid revenue, the hospital’s financial performance and negotiating posture with commercial payers may be particularly sensitive to changes in ED utilization and Medicaid reimbursement policy.

Medicaid: Complete Services Breakdown

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

531 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.	119,380	$300	$35.8M
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.	172,810	$170	$29.4M
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.	117,140	$140	$15.8M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	50,060	$140	$7.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	80,120	$60	$4.9M
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…	109,850	$40	$4.8M
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.	19,500	$180	$3.5M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	18,740	$120	$2.3M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	46,060	$50	$2.3M
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	42,560	$50	$2.3M

Showing 1–10 of 531

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

The William W Backus 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

531 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	10	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.	3	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.	4	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.	7	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.	4	110	1,520	$140	$3.4M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	4	10	330	$1,810	$3.3M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	4	10	2,820	$160	$1.6M
J3380	Injection, vedolizumab, intravenous, 1 mg	5	10	220	$3,930	$1.6M
S9480	Intensive outpatient psychiatric services, per diem	24	60	5,640	$110	$1.3M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	3	10	920	$230	$1.3M

Showing 1–10 of 531

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hartford Hospital	CT	General Acute Care Hospital	$0	$316.3M
The William W Backus Hospital	CT	General Acute Care Hospital	$0	$2.3M
Scott Stanat	CT	Adult Reconstructive Orthopaedic Surgery Physician	$241.1K	$0
Thomas Peter	CT	Nephrology Physician	$200.1K	$0
Altaf Rasool	CT	Nephrology Physician	$168.2K	$0
Mary Rose Tantoco	CT	Nephrology Physician	$168K	$0
Mark Muetterties	RI	Emergency Medicine Physician	$159.9K	$0
Atul Palkar	CT	Pulmonary Disease Physician	$156.4K	$0
Mukti Patel-prineas	CT	Family Medicine Physician	$144K	$0
Pampana Gowd	CA	Cardiovascular Disease Physician	$132.5K	$0

Nearby Providers

Other providers in the same ZIP code as The William W Backus Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Community And Family Services, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$63.8M
United Community And Family Services, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$24.8M
American Ambulance Service, Inc.	CT	Land Ambulance	$2.2M	$12.4M
United Community And Family Services, Inc	CT	Federally Qualified Health Center (FQHC)	$0	$7.7M
City Of Norwich Board Of Education	CT	Local Education Agency (LEA)	$0	$6.7M
Norwich Pediatric Group, P.C.	CT	Pediatrics Physician	$0	$3.4M
Norwich Ophthalmology Group, P.C.	CT	Ophthalmology Physician	$0	$2.9M
Hi Dental Care LLC	CT	Dental Clinic/Center	$0	$2.7M
Ob-gyn Services, P.C.	CT	Obstetrics & Gynecology Physician	$0	$2.3M
Ravi Prakash	CT	Pediatrics Physician	$0	$2.1M

The William W Backus Hospital — Billing Profile & Reimbursement Data

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The William W Backus 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