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.

Hemant K. Panchal, Md, PC. (NPI 1821668427)

Hemant K. Panchal, Md, PC. is a pediatrics physician provider located in Enfield, Connecticut. This profile covers 0 Medicare and 25 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	Hemant K. Panchal, Md, PC.
Address	170 Hazard Ave
City	Enfield
State	CT
ZIP	06082
Taxonomy	Pediatrics Physician
NPI Enumerated	June 28, 2021

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

25 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…	8,820	$70	$590.9K
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…	2,350	$100	$225.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,430	$40	$147.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	990	$50	$46.7K
92588	The provider performs this noninvasive, diagnostic test to help detect inner ear abnormalities to identify such conditions as functional hearing loss or differentiate between sensory and neural…	1,210	$40	$44.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	1,400	$30	$43.3K
99174	The provider uses instruments to conduct a vision screening exam on both eyes. The procedure includes analysis and report.	1,650	$20	$29.8K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,950	$10	$21.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	190	$110	$20.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	$100	$20K

Showing 1–10 of 25

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

Hemant K. Panchal, Md, PC. — 2 of 22 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

25 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…	494	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…	220	1,710	750	$30	$243.3K
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…	137	170	850	$80	$203.5K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	29	50	280	$90	$175.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	61	140	780	$40	$163.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	126	240	1,560	$20	$159.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	113	180	710	$70	$151.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	99	170	410	$70	$98K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	84	140	1,300	$10	$51.7K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	19	30	730	$20	$50.8K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Autism Sparkles LLC	CT	Behavior Analyst	$0	$8.5M
Town Of Enfield Board Of Education	CT	Ambulance	$644.9K	$3.3M
Enfield Public Schools	CT	Local Education Agency (LEA)	$0	$3.7M
New England Urgent Care Enfield LLC	CT	Urgent Care Clinic/Center	$0	$2.6M
Nanas 247 Home Care & Companion Agency LLC	CT	Home Health Agency	$0	$2.4M
Anne Marie Villa, M.d., P.C.	CT	Pediatrics Physician	$0	$1.8M
I Smile Dental Studio, P.C.	CT	Dental Clinic/Center	$0	$1.7M
Enfield Plaza Family Dental	CT	General Practice Dentistry	$0	$1.5M
Gus J Pappas Theodore J Pappas	CT	General Practice Dentistry	$0	$1.2M
Lily Yeh	CT	Optometrist	$63.7K	$773.9K

Hemant K. Panchal, Md, PC. — Billing Profile & Reimbursement Data

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Hemant K. Panchal, Md, 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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