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.

Connecticut Children's Specialty Group, Inc. (NPI 1669448882)

Key Findings

Field	Value
Entity Type	Organization
Organization	Connecticut Children's Specialty Group, Inc.
Address	282 Washington St
City	Hartford
State	CT
ZIP	06106
Taxonomy	Pediatrics Physician
NPI Enumerated	February 27, 2006

Payer Source	Total Paid
Medicaid	$59.8M
Medicare	$0

CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC. has no Medicare billing on file and $59.8M in lifetime Medicaid revenue, making its public claims footprint effectively single‑payer (Medicaid) for analysis. Because Medicare is absent from the dataset, any Medicare-side comparisons are not applicable for this entity and analyses should focus on Medicaid performance and statewide positioning.

Revenue is highly concentrated in three office/outpatient E/M codes: 99213, 99214, and 99215 together account for 41.2% of the provider's total Medicaid revenue. Those codes individually generated $7.4M (14.9%), $6.8M (13.8%), and $6.2M (12.5%) respectively, signaling strong dependence on established‑patient E/M encounters as the primary revenue drivers.

The code mix indicates core operations are pediatric ambulatory care and preventive services: high volumes for established E/Ms (99213/99214/99215) are complemented by preventive medicine codes 99391 ($1.6M, 3.2%), 99392 ($1.4M, 2.8%), and 99393 ($531.9K, 1.1%), plus vaccine administration 90471 ($498.8K, 1.0%). Substantial ophthalmology screening codes (92015 $1.1M, 2.3%; 92014 $564.6K, 1.1%) further suggest integrated vision services within a pediatric clinic model.

The presence of emergency, inpatient, and neonatal codes shows the group also manages acute and higher-acuity pediatric care: ED codes 99284 ($4.3M, 8.6%), 99283 ($3.6M, 7.2%), and 99285 ($1.6M, 3.2%) appear alongside inpatient subsequent care 99233 ($1.6M, 3.2%) and discharge management 99239 ($476.8K, 1.0%). Neonatal/critical care activity is visible via 99479 ($607.7K, 1.2%) and 99469 ($574.7K, 1.2%), consistent with involvement in newborn and NICU-level services.

Statewide competitive standing is strong and in many cases dominant: 99215 ranks #1 of 379 providers in-state (100th percentile; extreme outlier), while 99213 and 99214 rank #19 of 1714 and #20 of 1589 (both 99th percentile; extreme outlier). Multiple other codes—including 99203, 99244, 99243, 92015, 90471, and 90791—also sit at very high state percentiles or are labeled as 'extreme outlier,' indicating the group operates at volumes far above typical Connecticut peers for many pediatric services.

There is nuance in the outlier signal: several material codes are described in the dataset as typical or unremarkable despite generating substantive revenue. For example, 99284 is noted as an 87th percentile, 'typical, unremarkable volume for this code,' and 99285 is described as 71th percentile, 'typical, unremarkable volume for this code,' while 99469 is listed as '100th percentile; typical, unremarkable volume for this code' in a very small reporting population. These labels underscore that percentile ranks should be interpreted alongside the absolute provider counts and clinical context rather than as sole indicators of unusual activity.

The provider’s NPI was enumerated on 2006-02-27 (~20 years ago), reflecting long-tenured participation in Medicaid billing. Taken together with persistent high-volume rankings on core pediatric E/M and preventive codes, this tenure supports classifying the group as an established statewide pediatric provider whose contracting, capacity, and care‑management practices will materially affect Medicaid pediatric service delivery in Connecticut.

Medicaid: Complete Services Breakdown

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

230 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…	141,620	$50	$7.4M
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…	86,670	$80	$6.8M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	56,120	$110	$6.2M
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.	72,270	$60	$4.3M
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.	111,470	$30	$3.6M
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…	34,590	$70	$2.5M
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	19,800	$110	$2.2M
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.	17,410	$90	$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…	14,460	$110	$1.6M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	22,200	$70	$1.6M

Showing 1–10 of 230

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

Connecticut Children's Specialty Group, Inc. — 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

230 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	38	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.	17	130	690	$180	$4.7M
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	5	10	760	$3,080	$4.4M
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.	6	110	1,520	$140	$3.4M
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	3	10	1,810	$690	$1.2M
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	5	10	240	$2,190	$1M
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	4	10	590	$240	$989.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	4	60	3,070	$100	$907.8K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	3	50	870	$510	$687.2K
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…	29	80	790	$240	$650K

Showing 1–10 of 230

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tavish Nanda	MA	Ophthalmology Physician	$490.9K	$0
Mariam Aboukar	CT	Psychiatry Physician	$8.7K	$86.9K
Kristopher Kahle	CT	Neurological Surgery Physician	$59.4K	$0
Wei An	CT	Allergy & Immunology Physician	$37.7K	$0
Jason Lee	CT	Allergy & Immunology Physician	$31.7K	$0
Jay Kenkare	CT	Sleep Medicine (Internal Medicine) Physician	$29.7K	$0
Jacqueline Lagoy	CT	Anesthesiology Physician	$12K	$0
Anudeep Dodeja	CT	Pediatric Cardiology Physician	$980	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Connecticut Children's Medical Center	CT	Children's Hospital	$0	$248.8M
Hartford Dispensary	CT	Substance Use Disorder Rehabilitation Clinic/Center	$1.6M	$122.8M
Hartford Healthcare Medical Group Specialists, PLLC	CT	Surgery Physician	$0	$46M
Charter Oak Health Center, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$42.5M
Hartford Dispensary	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.1M
Aetna Ambulance Service, Inc	CT	Land Ambulance	$2.9M	$22.2M
Home Care Vna, LLC	CT	Home Health Agency	$0	$12.4M
Connecticut Gi PLLC	CT	Gastroenterology Physician	$0	$12M
Charter Oak Health Center, Inc.	CT	Federally Qualified Health Center (FQHC)	$0	$8M
Dierks Dialysis LLC	CT	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$4.2M

Connecticut Children's Specialty Group, Inc. — Billing Profile & Reimbursement Data

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Connecticut Children's Specialty Group, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References