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.

Starling Physicians, PLLC (NPI 1467537290)

Key Findings

Field	Value
Entity Type	Organization
Organization	Starling Physicians, PLLC
Address	2110 Silas Deane Hwy
City	Rocky Hill
State	CT
ZIP	06067
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 27, 2006

Payer Source	Total Paid
Medicaid	$38.1M
Medicare	$0

This provider is effectively single-payer in federal programs: there is no Medicare billing on file and all reported federal revenue is Medicaid-only, with total Medicaid revenue of $38.1M. That concentration means payers and network managers should treat Medicaid reimbursement and utilization patterns as the primary financial signal for this entity.

Revenue is highly concentrated in a small set of outpatient E/M codes: the precomputed top three Medicaid codes (99214, 99213, 99232) account for 48.9% of the provider's total Medicaid revenue. Individually, 99214 accounts for $7.6M (22.5%), 99213 for $6.3M (18.6%), and 99232 for $2.6M (7.8%), so these three codes together drive nearly half of all Medicaid receipts.

The code mix indicates a high-volume ambulatory internal medicine practice with substantial primary care throughput: 99214 and 99213 (established patient office visits) are the largest revenue drivers, implying frequent follow-up and routine chronic disease management encounters. At the same time, a cluster of preventive and pediatric well-visit codes (99392, 99393, 99391, 99394) and immunization administration (90460) shows the practice also delivers a large volume of pediatric preventive services and vaccinations on Medicaid.

Hospital-based and observation care are a meaningful part of the operation: 99232 (subsequent inpatient/observation care) is $2.6M and ranks #2 of 169 providers in-state (99th percentile, extreme outlier), and 99222 (initial inpatient) ranks #1 of 82 providers in-state (100th percentile). These rankings indicate the provider is not solely office-based and likely bills significant inpatient evaluation and management services.

The provider is a dominant statewide participant for several high-acuity and chronic-care services: 90960 (ESRD monthly care) generates $1.6M and ranks #1 of 21 providers in-state (100th percentile, extreme outlier), and 90935 (hemodialysis) also ranks #1 of 13 providers in-state (100th percentile, notably above typical state volume). This suggests an operational footprint that includes ongoing dialysis or ESRD management.

Several codes show the provider as an extreme or notable outlier in Connecticut, underscoring competitive strength in specific service lines: 99214 and 99213 are both in the 99th percentile (labeled extreme outlier), 99392 and 99393 are 98th percentile (notably above typical), and 87636 (SARS–CoV–2/flu multiplex testing) is 93rd percentile (notably above typical). These percentile positions imply market dominance for routine adult E/M and substantial volume in preventive and diagnostic testing.

Ancillary procedural mix complements the E/M-heavy profile: high ranks for allergy testing (95004 ranks #2 of 33, 97th percentile, notably above typical) and meaningful revenues from procedures such as intravitreal injection J0178 ($274.2K, rank #13 of 19, typical) indicate a breadth of outpatient procedures alongside core E/M and dialysis services. This diversity suggests the group bills across multiple ambulatory service types rather than a single narrow clinic line.

The provider has an established market presence, with NPI enumeration dated 2006-10-27 (~20 years ago). That tenure, combined with dominant in-state rankings on several codes, indicates a long-standing operational footprint that could influence contracting leverage and referral relationships within Connecticut Medicaid networks.

Medicaid: Complete Services Breakdown

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

269 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	162,710	$50	$7.6M
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…	170,550	$40	$6.3M
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…	139,470	$20	$2.6M
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	51,240	$40	$1.9M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17,360	$110	$1.9M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	13,030	$130	$1.6M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	15,750	$100	$1.6M
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	23,510	$70	$1.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	14,140	$100	$1.3M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	9,990	$110	$1.1M

Showing 1–10 of 269

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

Starling Physicians, PLLC — 18 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

269 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	Injection, aflibercept, 1 mg	13	20	1,420	$570	$2.4M
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.	32	30	17,770	$50	$1.1M
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…	19	40	1,910	$190	$1.1M
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.	26	40	5,360	$120	$1M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	35	40	15,430	$40	$744.3K
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	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…	21	100	1,120	$120	$564.2K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	2	30	530	$320	$553.7K
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…	92	350	1,820	$40	$537.3K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	38	50	1,820	$100	$515.7K

Showing 1–10 of 269

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Starling Physicians, PLLC	CT	Clinical Medical Laboratory	$809.9K	$4.4M
Yousong Wang	CT	General Practice Physician	$861.3K	$0
Edward Fitzpatrick	CT	Ophthalmology Physician	$757.6K	$0
Nauman Piracha	CT	Hospitalist Physician	$489.5K	$104.3K
Stephen Firshein	CT	Hematology & Oncology Physician	$587.4K	$0
Sakshi Kapur	NJ	Internal Medicine Physician	$391.6K	$0
Matthew Brown	CT	Surgery Physician	$355.3K	$0
Katherine Davoren	RI	Nephrology Physician	$82.9K	$238.5K
Lawrence Giove	CT	Hematology & Oncology Physician	$302.2K	$0
Michael Lawlor	CT	Infectious Disease Physician	$299.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New England Home Care Inc.	CT	Home Health Agency	$0	$397.1M
Physicians For Women's Health LLC	CT	Obstetrics & Gynecology Physician	$0	$57.3M
Priority Care, Inc.	CT	Home Health Agency	$0	$53.5M
Connecticut Addiction Medicine, LLC	CT	Addiction Psychiatry Physician	$0	$21.1M
Atg Connecticut Inc	CT	Customized Equipment (DME)	$0	$19.9M
Centerwell Certified Healthcare Corp.	CT	Home Health Agency	$0	$17M
Masters In Home Care, LLC	CT	Home Health Agency	$0	$10M
Mc Diagnostic Of Connecticut, P.C.	CT	Family Nurse Practitioner	$0	$4.7M
Rocky Hill Surgery Center, LLC	CT	Ambulatory Surgical Clinic/Center	$1.3M	$254.9K
Rocky Hill Public Schools	CT	Local Education Agency (LEA)	$0	$1.4M

Starling Physicians, PLLC — 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