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.

Gaylord Hospital, Inc. (NPI 1730137753)

Gaylord Hospital, Inc. is a long term care hospital provider located in Wallingford, Connecticut. This profile covers 0 Medicare and 52 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	Gaylord Hospital, Inc.
Address	50 Gaylord Farm Rd
City	Wallingford
State	CT
ZIP	06492
Taxonomy	Long Term Care Hospital
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$14.6M
Medicare	$0

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	124,630	$60	$7M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	31,850	$30	$1M
97113	The provider instructs and supervises the patient on aquatic therapeutic exercises for one or more areas of the body for a period of 15 minutes.	18,500	$50	$999.2K
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…	9,090	$70	$590.8K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	20,060	$30	$541.6K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	7,470	$70	$538K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	15,600	$30	$514.8K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	6,730	$50	$363.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	5,950	$60	$362.6K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	800	$450	$356.4K

Showing 1–10 of 52

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

Gaylord Hospital, Inc. — 7 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

52 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	28	40	21,520	$90	$8M
J0585	Injection, onabotulinumtoxina, 1 unit	15	20	1,530	$380	$1M
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…	8	350	1,820	$40	$537.3K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	107	110	6,910	$30	$524.1K
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…	43	150	3,670	$60	$470.9K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	10	50	1,420	$20	$338.6K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	14	50	2,660	$50	$256.2K
97127	N/A	1	10	2,830	$90	$247.7K
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…	557	1,710	750	$30	$243.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,052	2,180	850	$90	$202.1K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Reynolds	CT	Nephrology Physician	$160.6K	$0
William Farrell	CT	Cardiovascular Disease Physician	$129.1K	$0
Mohammed Yosufzai	CT	Internal Medicine Physician	$61.7K	$0
Randy Schulman	CT	Vision Therapy Optometrist	$35.4K	$0
Anton Cherry	CT	Medical Physician Assistant	$30.5K	$0
Luci Juvan	CT	Physical Medicine & Rehabilitation Physician	$20.1K	$0
Anthony Rinaldi	CT	Clinical Neuropsychologist	$17.3K	$0
David Chen	CT	Physical Medicine & Rehabilitation Physician	$16.2K	$0
Emily Williamson	CT	Clinical Neuropsychologist	$15.9K	$0
Nadia Pare	CT	Clinical Neuropsychologist	$6.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Masonicare Home Health And Hospice, Inc.	CT	Home Health Agency	$0	$13M
Robinson PA, LLC	CT	Interventional Pain Medicine Physician	$0	$6.9M
Town Of Wallingford	CT	Local Education Agency (LEA)	$0	$3.9M
Park Avenue Medical	CT	Internal Medicine Physician	$0	$3.4M
Wallingford Endoscopy Center, LLC.	CT	Endoscopy Clinic/Center	$322.7K	$1.8M
Town Of Wallingford	CT	Ambulance	$493.3K	$1.6M
Promptcare New England Respiratory, LLC	CT	Oxygen Equipment & Supplies (DME)	$0	$1.8M
The Promptcare Companies, Inc.	CT	Durable Medical Equipment & Medical Supplies	$0	$1.8M
Meriden Imaging Center, Inc.	CT	Diagnostic Radiology Physician	$0	$1.7M
Lincare Inc.	CT	Durable Medical Equipment & Medical Supplies	$0	$1.5M

Gaylord Hospital, Inc. — Billing Profile & Reimbursement Data

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Gaylord Hospital, Inc. — 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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