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.

Danbury Hospital (NPI 1548293343)

Field	Value
Entity Type	Organization
Organization	Danbury Hospital
Address	24 Hospital Ave
City	Danbury
State	CT
ZIP	06810
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 8, 2006

Payer Source	Total Paid
Medicaid	$123.8M
Medicare	$0

Key Findings

This provider is effectively single-payer for Medicare/Medicaid reporting: DANBURY HOSPITAL shows no Medicare billing on file and $123.8M in lifetime Medicaid revenue, so Medicaid represents the entirety of recorded federal-payer revenue. That concentration means analyses of federal reimbursement and utilization for this hospital must be interpreted through a Medicaid-only lens rather than a dual Medicare/Medicaid view.

Revenue is highly concentrated in emergency department evaluation-and-management codes: the precomputed top three Medicaid codes (99285, 99284, 99283) together account for 52.2% of the provider’s total Medicaid revenue. Individually those codes are reported as 99285 $23.3M (24.8%), 99284 $14.1M (14.9%), and 99283 $11.8M (12.5%), signaling that ED services are the primary revenue driver on Medicaid.

The ED code mix indicates a high-volume, high-acuity emergency practice. 99285 (high-level ED visit) generates $23.3M and ranks #10 of 129 providers in-state (93th percentile) and is described as notably above typical state volume for this code, while 99284 and 99283 also appear as large contributors ($14.1M and $11.8M) and rank in the 90th+ percentiles even though each is characterized as typical, unremarkable volume for its code.

Beyond emergency care, the hospital shows strong outpatient therapy and procedural GI lines. Therapeutic exercise 97110 accounts for $7.1M (7.5% of Medicaid revenue) and ranks #9 of 348 providers in-state (98th percentile), described as notably above typical state volume for this code; colonoscopy/biopsy and polypectomy codes such as 45380 ($3.1M), 45385 ($2.0M), and 43239 ($2.7M) also appear prominently and are variously ranked in the top deciles statewide (45380 and 45385 are noted as notably above typical state volume for those codes).

The hospital maintains significant infusion, chemotherapy, and IV medication activity consistent with an active outpatient infusion/oncology service line. Codes for rapid IV push and infusion (96374 $4.6M; 96365 $1.3M; 96375 $1.0M) and chemotherapy administration (96413 $1.5M) together represent a meaningful component of Medicaid revenue, indicating ongoing parenteral medication throughput beyond ED use.

Diagnostic imaging, cardiology testing, and vascular studies are material contributors to the facility’s Medicaid mix. Echocardiography 93306 ($2.1M), CT abdomen/pelvis 74177 ($2.0M), head CT 70450 ($1.4M), and abdominal duplex 93975 ($1.0M, ranked #4 of 42 and described as notably above typical state volume for this code) point to substantial diagnostic capacity supporting both inpatient and outpatient workflows.

Laboratory and infectious-disease testing volumes are elevated in select areas. Molecular respiratory testing 87637 generates $1.0M and ranks #2 of 39 providers in-state (97th percentile) and is described as notably above typical state volume for this code; SARS-CoV-2 testing U0004 also appears ($1.8M) at otherwise typical volumes. These patterns suggest sustained lab throughput for respiratory and infectious testing.

DANBURY HOSPITAL is an established facility with a long NPI tenure (enumerated 2006-07-08, ~20 years), and the Medicaid-only revenue profile implies concentrated reimbursement exposure to Medicaid policy and rate changes. Combined high statewide ranks for ED, therapy, GI procedures, infusion, imaging, and selected lab codes position the hospital as a major in-state provider across those service lines, while the lack of Medicare billing on file should be treated as a material characteristic when assessing payer mix risk and competitive comparisons.

Medicaid: Complete Services Breakdown

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

525 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.	77,020	$300	$23.3M
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.	84,380	$170	$14.1M
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.	79,170	$150	$11.8M
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…	117,600	$60	$7.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	33,230	$140	$4.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	41,080	$80	$3.1M
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…	4,700	$650	$3.1M
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.	6,400	$420	$2.7M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	22,370	$100	$2.3M
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…	8,170	$260	$2.1M

Showing 1–10 of 525

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

Danbury Hospital — 2 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

525 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	13	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.	10	130	520	$330	$5.9M
J9271	Injection, pembrolizumab, 1 mg	8	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.	11	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.	12	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.	12	110	1,520	$140	$3.4M
44970	Laparoscopy, surgical, appendectomy	3	10	230	$4,770	$1.7M
S9480	Intensive outpatient psychiatric services, per diem	13	60	5,640	$110	$1.3M
Q5111	Injection, pegfilgrastim-cbqv (udenyca), biosimilar, 0.5 mg	2	10	270	$2,020	$1.2M
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	11	10	160	$4,170	$1.1M

Showing 1–10 of 525

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Crystal Run Healthcare Physicians LLP	NY	General Practice Physician	$0	$34.1M
Nuvance Health Medical Practice Ct, Inc.	CT	Internal Medicine Physician	$0	$20.2M
Danbury Hospital	CT	General Acute Care Hospital	$0	$15.3M
Granit Veseli	CT	Clinical Cardiac Electrophysiology Physician	$567.3K	$10
Michael Spiegel	CT	Rheumatology Physician	$488.7K	$0
Sydney Page	CT	Medical Physician Assistant	$398.3K	$0
Sanjay Gupta	CT	Orthopaedic Surgery Physician	$397.9K	$0
Behzad Habibi Khameneh	CT	Neurology Physician	$394.4K	$0
Donald Sonn	MA	Urology Physician	$367.6K	$0
Gillian Levy	CT	Anatomic Pathology & Clinical Pathology Physician	$361.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Family And Children's Aid, Inc.	CT	Adolescent and Children Mental Health Clinic/Center	$0	$64M
Midwestern Connecticut Council On Alcoholism, Inc	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$39.9M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$32.8M
Connecticut Institute For Communities Inc	CT	Federally Qualified Health Center (FQHC)	$0	$14.9M
Connecticut Counseling Centers, Inc.	CT	Methadone Clinic	$243.5K	$12.1M
Center For Pediatric Medicine	CT	Pediatrics Physician	$0	$9.4M
Optimum Medical LLC	CT	Pediatrics Physician	$0	$8.9M
Kids Dental Specialists LLC	CT	Pediatric Dentistry	$0	$7.8M
Danbury Public Schools	CT	Local Education Agency (LEA)	$0	$7.3M
Childcare Associates	CT	Pediatrics Physician	$0	$6.8M

Danbury 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