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.

Park Avenue Medical (NPI 1740546399)

Field	Value
Entity Type	Organization
Organization	Park Avenue Medical
Address	85 Barnes Rd Ste 202
City	Wallingford
State	CT
ZIP	06492
Taxonomy	Internal Medicine Physician
NPI Enumerated	April 9, 2012

Payer Source	Total Paid
Medicaid	$3.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	14,820	$90	$1.3M
99417	The provider spends additional time on an outpatient evaluation and management service. Use this code for each additional 15 minutes beyond the minimum required time.	3,640	$210	$761.6K
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…	5,260	$120	$620.6K
S0013	Esketamine, nasal spray, 1 mg	270	$910	$245.3K
17999	Unlisted procedure, skin, mucous membrane, and subcutaneous tissue.	710	$260	$185K
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…	1,350	$60	$81.1K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	5,930	$10	$59.3K
99355	N/A	360	$90	$31.7K
99442	N/A	550	$40	$22.6K
99354	N/A	380	$40	$16.5K

Showing 1–10 of 19

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

Park Avenue Medical — 4 of 18 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	119	1,590	740	$50	$331.8K
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…	696	1,710	750	$30	$243.3K
S0013	Esketamine, nasal spray, 1 mg	1	10	230	$950	$215.7K
17999	Unlisted procedure, skin, mucous membrane, and subcutaneous tissue.	1	10	650	$310	$146.1K
99417	The provider spends additional time on an outpatient evaluation and management service. Use this code for each additional 15 minutes beyond the minimum required time.	3	20	480	$130	$142.1K
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…	25	380	220	$70	$99.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	70	200	530	$20	$69.3K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	243	290	470	$10	$41.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	120	140	150	$60	$38.6K
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	60	100	970	$10	$34.3K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Park Avenue Medical, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gaylord Hospital, Inc.	CT	Long Term Care Hospital	$0	$14.6M
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
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

Park Avenue Medical — Billing Profile & Reimbursement Data

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Park Avenue Medical — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References