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.

Midstate Gastroenterology Specialists PC (NPI 1487677951)

Midstate Gastroenterology Specialists PC is a gastroenterology physician provider located in Meriden, Connecticut. This profile covers 0 Medicare and 34 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Midstate Gastroenterology Specialists PC
Address	455 Lewis Ave
City	Meriden
State	CT
ZIP	06451
Taxonomy	Gastroenterology Physician
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	30,880	$40	$1.3M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	7,500	$160	$1.2M
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…	10,860	$60	$662.5K
88313	The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…	5,620	$100	$550.6K
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…	5,640	$100	$536.2K
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.	10,170	$50	$498.4K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	5,560	$70	$383.8K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	3,630	$80	$297.4K
00813	The anesthesia provider performs anesthesia services for a patient undergoing both upper and lower intestinal endoscopy where the surgical provider introduces an endoscope into the intestines above…	2,900	$70	$211.8K
99203	The provider sees a new 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 provider…	3,360	$60	$194.9K

Showing 1–10 of 34

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

Midstate Gastroenterology Specialists PC — 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	10	330	$1,810	$3.3M
J3380	Injection, vedolizumab, intravenous, 1 mg	3	10	220	$3,930	$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…	25	40	1,910	$190	$1.1M
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	70	570	$480	$626.7K
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.	4	80	990	$260	$592K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	36	90	3,980	$40	$424.8K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	16	60	370	$460	$368K
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…	146	1,590	740	$50	$331.8K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	16	40	290	$460	$264.7K
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…	70	1,710	750	$30	$243.3K

Showing 1–10 of 34

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Housein Wazaz	CT	Gastroenterology Physician	$229.1K	$0
Manu Sethi	OH	Anesthesiology Physician	$43.5K	$0
Glen Rosenfeld	CT	Anesthesiology Physician	$28.4K	$0
Kwok Chan	CA	Anesthesiology Physician	$17K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midstate Medical Center	CT	General Acute Care Hospital	$0	$110.8M
Hunter's Ambulance Service, Inc.	CT	Ambulance	$4.2M	$25.5M
Emergency Medicine Physicians Of New Haven County,llc	CT	Emergency Medicine Physician	$0	$8.6M
Midstate Radiology Associates, LLC	CT	Diagnostic Radiology Physician	$0	$6.6M
Nems PLLC	CT	Emergency Medicine Physician	$0	$6.1M
B.e.k Eyecare, Inc	CT	Optometrist	$0	$3.7M
Apple Dental And Associates,llc	CT	General Practice Dentistry	$0	$2.1M
Connecticut Counseling Centers, Inc	CT	Methadone Clinic	$0	$2M
Franciscan Family Care Center, Inc.	CT	Home Health Agency	$0	$1.8M
Midstate Medical Center	CT	General Acute Care Hospital	$0	$1.3M

Midstate Gastroenterology Specialists PC — Billing Profile & Reimbursement Data

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Midstate Gastroenterology Specialists PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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