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.

Adult Day Care Of America, Inc. (NPI 1538285879)

Field	Value
Entity Type	Organization
Organization	Adult Day Care Of America, Inc.
Address	2 Corporate Dr Ste 146
City	Shelton
State	CT
ZIP	06484
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$35.1M
Medicare	$0

Key Findings

This entity reports no Medicare billing on file (none (no Medicare billing on file)) and is effectively a single-payer Medicaid operator with $35.1M in lifetime Medicaid revenue. The absence of Medicare activity alongside material Medicaid revenue indicates the organization’s financial footprint and referral base are concentrated in state-funded long-term/supportive care programs rather than Medicare-covered services.

Revenue concentration is extremely high: the precomputed top-3 Medicaid codes account for 93.9% of this provider’s total Medicaid revenue. In particular, 1021Z generates $22M (62.5% of total Medicaid revenue), 1023Z generates $5.9M (16.7%), and 1210Z generates $5.1M (14.6%), showing that a very small set of codes drives nearly all Medicaid income.

Code-level volumes show scale and operational intensity: 1021Z has 184.6K claims at $119 avg paid/claim for $22M in revenue and ranks #1 of 54 providers in-state (100th percentile; extreme outlier, far above typical state volume for this code). This single code’s volume and rank indicate the provider is the dominant statewide supplier for that billed service and likely organizes high-throughput delivery around it.

1023Z and 1210Z likewise show strong statewide dominance: 1023Z has 26.9K claims at $218 avg paid/claim for $5.9M and ranks #1 of 12 providers in-state (100th percentile; notably above typical state volume), while 1210Z has 88.6K claims at $58 avg paid/claim for $5.1M and ranks #1 of 17 providers in-state (100th percentile; extreme outlier). These ranks and percentile placements mark the provider as a major in-state participant for multiple high-revenue Medicaid codes.

A fourth listed code, 1214Z, contributes $2.2M (6.1% of Medicaid revenue) with 80K claims at $27 avg paid/claim and also ranks #1 of 20 providers in-state (100th percentile; extreme outlier). Although outside the top three by revenue share, 1214Z reinforces the pattern that this provider concentrates large claim volumes across several related Medicaid service codes.

Business and service-line implications: the provider’s name and taxonomy (ADULT DAY CARE OF AMERICA, INC.; In Home Supportive Care Agency) together with the heavy Medicaid code concentration suggest operations are centered on Medicaid-funded adult day and in-home supportive services. Even though specific code descriptions are not available in the dataset, the combination of high claim counts and large Medicaid payments is consistent with high-volume, recurrent supportive-care encounters rather than sporadic acute procedures.

Competitive standing within Connecticut is dominant for the principal billed services: three separate codes show the provider at rank #1 statewide and at the 100th percentile, with two codes explicitly labeled “extreme outlier” and one as “notably above typical.” This pattern indicates the provider is a top market participant in its service niche and likely captures material share of Medicaid-funded adult supportive-care utilization locally.

Tenure and operational longevity are notable: the NPI was enumerated on 2007-03-21 (~19 years ago), indicating long-established presence in the market. Combined with the concentrated Medicaid revenue and top statewide rankings, the provider appears to have sustained a stable, Medicaid-focused delivery model over nearly two decades.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
1021Z	N/A	184,640	$120	$22M
1023Z	N/A	26,890	$220	$5.9M
1210Z	N/A	88,560	$60	$5.1M
1214Z	N/A	79,980	$30	$2.2M

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

Adult Day Care Of America, Inc. — 4 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
1023Z	N/A	1	10	3,080	$240	$1.3M
1021Z	N/A	1	50	3,560	$130	$1M
1210Z	N/A	1	20	480	$60	$430.8K
1214Z	N/A	1	20	1,030	$30	$173.2K

Nearby Providers

Other providers in the same ZIP code as Adult Day Care Of America, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Services Of America, LLC	CT	Home Health Agency	$0	$92.9M
Dianon Systems, Inc	CT	Clinical Medical Laboratory	$4.9M	$8.5M
Option Care Enterprises, Inc	CT	Home Infusion Therapy Pharmacy	$0	$13.3M
Ameripath New York LLC	CT	Clinical Medical Laboratory	$2.9M	$7.7M
Esoterix Genetic Laboratories, LLC	CT	Clinical Medical Laboratory	$2.2M	$3.2M
Enzo Clinical Labs, Inc.	CT	Clinical Medical Laboratory	$0	$3.8M
Bridgeport Radiological Associates LLC	CT	Diagnostic Radiology Physician	$0	$2.9M
Shelton Pediatrics	CT	Pediatrics Physician	$0	$2.7M
Echo Hose Hook And Ladder Ambulance Corps., Inc.	CT	Land Ambulance	$568.5K	$1.7M
Shelton Dental Group LLC	CT	Dentist	$0	$2.1M

Adult Day Care Of America, Inc. — Billing Profile & Reimbursement Data

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Adult Day Care Of America, Inc. — 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

Nearby Providers

Frequently Asked Questions

References