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.

Franklin Medical Group, PC (NPI 1780686964)

Franklin Medical Group, PC is a internal medicine physician provider located in Waterbury, Connecticut. This profile covers 0 Medicare and 192 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	Franklin Medical Group, PC
Address	56 Franklin St
City	Waterbury
State	CT
ZIP	06706
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 1, 2005

Payer Source	Total Paid
Medicaid	$13.5M
Medicare	$0

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

192 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…	102,210	$50	$5.2M
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…	51,760	$40	$1.9M
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.	9,840	$40	$423.2K
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…	6,500	$60	$396.5K
99204	The provider sees a new 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 provider…	3,900	$90	$355K
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.	4,520	$70	$307.2K
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…	12,750	$20	$267.8K
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…	2,300	$100	$238.8K
99392	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…	1,970	$110	$222.6K
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…	4,280	$40	$188.3K

Showing 1–10 of 192

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

Franklin Medical Group, PC — 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

192 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.	50	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.	48	130	690	$180	$4.7M
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.	52	110	1,520	$140	$3.4M
J0585	Injection, onabotulinumtoxina, 1 unit	19	20	1,530	$380	$1M
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.	37	60	3,070	$100	$907.8K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	37	40	15,430	$40	$744.3K
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,…	23	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…	10	80	790	$240	$650K
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…	34	70	570	$480	$626.7K
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.	23	80	990	$260	$592K

Showing 1–10 of 192

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Trinity Health Of New England Provider Network Organization Inc	CT	Internal Medicine Physician	$0	$42M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Saint Francis Care Medical Group, PC	CT	Anatomic Pathology & Clinical Pathology Physician	$0	$2M
Robert Smith	CT	Specialist	$33.8K	$1.1M
Yuyang Zhang	MD	Diagnostic Radiology Physician	$920.4K	$0
Sachin Parekh	CT	Emergency Medicine Physician	$807.9K	$0
David Fleszar	FL	Diagnostic Radiology Physician	$754K	$0
Andrew Griscom	RI	Emergency Medicine Physician	$20.8K	$615.7K
Jeffrey Thompsen	CT	Cardiovascular Disease Physician	$424.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Mary's Hospital, Inc.	CT	General Acute Care Hospital	$0	$163.2M
Trinity Health Of New England Emergency Medical Services, Inc.	CT	Ambulance	$2.5M	$13M
Middle Ct Emergency Physicians LLC	CT	Emergency Medicine Physician	$0	$6.8M
Campion Ambulance Service Inc	CT	Ambulance	$0	$4.5M
Naugatuck Valley Radiological Associates PC	CT	Diagnostic Radiology Physician	$0	$2.1M
Brass Mill Mall Dental L.L.P	CT	General Practice Dentistry	$0	$1.3M
Joseph Pruner	CT	Internal Medicine Physician	$211.3K	$0
Monica Hughes	CT	Adult Health Nurse Practitioner	$176.2K	$0
Sarah Gao	CT	Therapeutic Radiology Physician	$169.7K	$0
Reza Pakdaman	CT	Diagnostic Radiology Physician	$160.6K	$0

Franklin Medical Group, PC — Billing Profile & Reimbursement Data

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Franklin Medical Group, PC — 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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