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.

Metabolism Associates PC (NPI 1861473787)

Metabolism Associates PC is a nephrology physician provider located in New Haven, Connecticut. This profile covers 0 Medicare and 12 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	Metabolism Associates PC
Address	136 Sherman Ave
City	New Haven
State	CT
ZIP	06511
Taxonomy	Nephrology Physician
NPI Enumerated	November 8, 2005

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.

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	5,640	$90	$518.7K
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…	29,240	$20	$467.9K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	5,000	$30	$140K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	730	$80	$60.1K
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…	1,630	$30	$42.4K
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…	520	$30	$14.1K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	750	$20	$13.6K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1,310	$10	$10.5K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	250	$30	$6.7K
99253	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	60	$50	$2.7K

Showing 1–10 of 12

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

Metabolism Associates PC — 0 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	8	20	3,350	$80	$404.1K
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…	587	1,590	740	$50	$331.8K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	4	10	1,760	$90	$279K
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…	956	1,710	750	$30	$243.3K
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…	12	170	260	$20	$183.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	24	60	290	$10	$107K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	36	80	180	$40	$41.6K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	4	20	60	$70	$27K
99442	N/A	205	220	170	$10	$25.9K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	9	40	220	$30	$22.8K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Yale University	CT	Anesthesiology Physician	$0	$137.3M
Planned Parenthood Of Southern New England, Inc.	CT	Ambulatory Family Planning Facility	$0	$37.9M
Yale New Haven Health At Home, Inc.	CT	Home Health Agency	$0	$17M
Yale-new Haven Hospital	CT	Pediatric Dentistry	$0	$13.7M
Apt Foundation Inc	CT	Methadone Clinic	$1.2M	$11.6M
Clifford W. Beers Guidance Clinic Inc	CT	Adolescent and Children Mental Health Clinic/Center	$0	$11.6M
Chemical Abuse Services Agency, Inc.	CT	Community/Behavioral Health Agency	$162.8K	$10.6M
New Era Rehabilitation Center, Inc.	CT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.7M
Sanjay Aggarwal	CT	Internal Medicine Physician	$0	$4.5M
Kristi Rossomando	CT	General Practice Dentistry	$0	$4M

Metabolism Associates PC — Billing Profile & Reimbursement Data

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Metabolism Associates 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Radu Raducu	ND	Nephrology Physician	$466.9K	$0
Mark Hotchkiss	CT	Nephrology Physician	$137.4K	$0
Hugh Carey	CT	Nephrology Physician	$134.4K	$0
Joni Hansson	CT	Nephrology Physician	$107.1K	$0
Thomas Eisen	CT	Nephrology Physician	$80.3K	$0
Laura Troidle	CT	Physician Assistant	$54.3K	$0
Peter Juergensen	CT	Physician Assistant	$29.6K	$0