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.

Norwalk Community Health Center Inc (NPI 1841226347)

Key Findings

Field	Value
Entity Type	Organization
Organization	Norwalk Community Health Center Inc
Address	120 Connecticut Avenue
City	Norwalk
State	CT
ZIP	06854
Taxonomy	Health Service Clinic/Center
NPI Enumerated	June 25, 2006

Payer Source	Total Paid
Medicaid	$29.2M
Medicare	$0

This provider is effectively single‑payer in the claims data: there is no Medicare billing on file and total Medicaid revenue is $29.2M, indicating a Medicaid‑centric operating footprint rather than a mixed Medicare/Medicaid practice mix. The absence of Medicare activity means analyses of senior care patterns or Medicare benchmarking are not applicable for this entity.

Revenue is highly concentrated: the precomputed top‑3 Medicaid codes account for 98.3% of the provider’s Medicaid revenue, with T1015 alone representing $27.2M or 93.2% of total Medicaid revenue. That concentration points to a business model where a single bundled clinic/encounter code is the dominant revenue driver.

The service mix implied by the highest‑revenue codes aligns with an FQHC/RHC clinic model: T1015 (Clinic visit/encounter, all‑inclusive) is dominant, and other significant codes include G0511 (general care management for RHC/FQHC) with $895K in revenue and G0467 (FQHC visit, established patient) appearing in the code list. Together these codes suggest the organization operates as a community health center providing bundled primary care and chronic care management rather than fee‑for‑service specialty procedures.

Competitive standing is mixed by code: for its top revenue driver T1015 the provider ranks #16 of 73 in‑state (79th percentile) — described in the source as a typical, unremarkable volume — so despite T1015 driving most revenue the provider is not an outlier for that code statewide. By contrast, the office E/M code 99213 shows very high volume: $588.4K in revenue from 84.1K claims and ranks #30 of 1714 providers in‑state (98th percentile), characterized as notably above typical state volume; this indicates the site delivers a very large number of low‑level outpatient encounters relative to peers.

Telehealth, telephonic care, and behavioral health appear as meaningful components of activity: 99442 has 30.2K claims and $60.4K revenue (ranks #7 of 223, 97th percentile, noted as notably above typical), G2025 telehealth distant site payments generate $129.7K (2.6K claims, 50th percentile), and psychotherapy 90834 yields $104.3K (8.7K claims, 90th percentile). These patterns point to a substantial reliance on remote/telephone visits and integrated behavioral health alongside in‑person clinic encounters.

Several high‑volume procedure and preventive codes show large claim counts but $0 reported Medicaid revenue (for example 90471 with 18.4K claims and 98th percentile extreme outlier status, 83026 with 15.8K claims and $0 revenue, and 96127 with 9.7K claims and $0 revenue). That pattern suggests many preventive, immunization, screening, or brief assessment services are being provided or billed in ways that do not generate separate Medicaid fee‑for‑service payments in the dataset (e.g., bundled payments, alternate funding, or state program billing flows), and these activities materially increase service volume without increasing the fee‑for‑service revenue line.

The provider’s tenure is long enough to indicate an established presence: the NPI was enumerated on 2006‑06‑25 (~20 years ago), implying sustained operations and likely longstanding relationships with Medicaid programs and local referral networks. That longevity may support continuity of care and institutional knowledge in operating under FQHC/RHC payment constructs.

Concentration risk is a clear operational consideration: with T1015 accounting for $27.2M (93.2% of Medicaid revenue) and the top three codes totaling 98.3% of revenue, any changes to FQHC/RHC bundled payment rules, clinic encounter valuation, or state policy affecting T1015/G0511/G0467 could materially impact the provider’s revenue. Conversely, the provider’s very high volumes in certain low‑paid E/M and telephonic codes (e.g., 99213 and 99442 ranked in the top few percentiles) may represent negotiating leverage or operational capacity to absorb shifts toward telehealth or episodic chronic care reimbursement models.

Medicaid: Complete Services Breakdown

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

93 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	180,010	$150	$27.2M
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	12,610	$70	$895K
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…	84,050	$10	$588.4K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	2,590	$50	$129.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	8,690	$10	$104.3K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	7,760	$10	$100.9K
99442	N/A	30,190	$1	$60.4K
82962	Blood glucose monitoring at home with small electronic devices is an easy method to check blood sugar level on a daily basis. The patient himself can perform the procedure and the result is obtained…	10,580	$10	$52.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,600	$10	$16K
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,…	3,020	$10	$15.1K

Showing 1–10 of 93

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

Norwalk Community Health Center Inc — 2 of 21 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

93 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	16	70	830	$150	$24M
G0511	Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…	8	20	6,040	$40	$952.7K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	51	50	1,820	$100	$515.7K
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…	391	1,590	740	$50	$331.8K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	14	30	2,590	$60	$278.5K
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…	30	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…	26	170	850	$80	$203.5K
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…	1,404	2,180	850	$90	$202.1K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	192	420	1,230	$20	$199.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	60	570	410	$50	$197.6K

Showing 1–10 of 93

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compassionate Home Care, LLC	CT	Home Health Agency	$0	$4.1M
Connecticut Counseling Centers, Inc	CT	Methadone Clinic	$0	$3.8M
Connecticut Counseling Centers, Inc.	CT	Adult Mental Health Clinic/Center	$0	$2.6M
Southern Connecticut Eye Care PC	CT	Optometrist	$0	$1.5M
Valentina Amelio	CT	Occupational Therapist	$101.1K	$0
Alphonse Paolillo	CT	Family Nurse Practitioner	$10.6K	$0
Kimberly Daros	CT	Registered Nurse	$1K	$0

Norwalk Community Health Center Inc — Billing Profile & Reimbursement Data

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Norwalk Community Health Center 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

Nearby Providers

Frequently Asked Questions

References