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.

Middlesex Hospital (NPI 1851350664)

Middlesex Hospital is a family medicine physician provider located in Middletown, Connecticut. This profile covers 0 Medicare and 44 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	Middlesex Hospital
Address	90 S Main St
City	Middletown
State	CT
ZIP	06457
Taxonomy	Family Medicine Physician
NPI Enumerated	March 21, 2006

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

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

44 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…	29,940	$50	$1.6M
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…	12,530	$70	$902.4K
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.	1,650	$40	$69.3K
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…	170	$120	$20.7K
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…	150	$140	$20.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,590	$10	$17.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	2,650	$10	$13.3K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	70	$90	$6.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	40	$110	$4.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	370	$10	$4.1K

Showing 1–10 of 44

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

Middlesex Hospital — 1 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	29	30	1,560	$160	$444.1K
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…	137	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…	77	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…	126	170	850	$80	$203.5K
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…	351	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…	450	570	410	$50	$197.6K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	76	170	260	$20	$183.2K
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…	112	160	680	$70	$166.1K
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.	119	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.	150	180	710	$70	$151.2K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Middlesex Hospital	CT	General Acute Care Hospital	$0	$116.1M
Middlesex Hospital	CT	Family Nurse Practitioner	$0	$7.5M
Middlesex Hospital	CT	Land Ambulance	$1.4M	$2M
Middlesex Hospital	CT	Home Health Agency	$0	$2.9M
Matthew Moyer	CT	Primary Care Nurse Practitioner	$220.7K	$0
Bikash Chapagain	CA	Nephrology Physician	$181.3K	$0
George Khouri	NC	Neurology Physician	$139.3K	$0
Meredith Lindner	CT	Internal Medicine Physician	$123K	$0
Zhenghao Zhang	MA	Internal Medicine Physician	$105.6K	$0
Jorge Donado	CT	Hospitalist Physician	$100.7K	$530

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Center Inc	CT	Federally Qualified Health Center (FQHC)	$0	$533.4M
Rushford Center Inc	CT	Substance Abuse Rehabilitation Facility	$0	$23M
Pursuecare, LLC	CT	Addiction Medicine (Preventive Medicine) Physician	$0	$9.8M
Gilead Community Services, Inc.	CT	Adult Mental Health Clinic/Center	$0	$8.9M
Mhs Primary Care, Inc	CT	Family Medicine Physician	$0	$5.4M
City Of Middletown	CT	Local Education Agency (LEA)	$0	$4.2M
Surgi-care, Inc	CT	Prosthetic/Orthotic Supplier	$0	$4.2M
Unison Health Services, Inc.	CT	Home Health Agency	$0	$3.8M
Healthdrive Behavioral Health Services, PLLC	CT	Geriatric Psychiatry Physician	$0	$3.2M
Dme Living Well, LLC	CT	Oxygen Equipment & Supplies (DME)	$0	$2.5M

Middlesex Hospital — 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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