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.

Connecticut Pulmonary Specialists, PC (NPI 1922397298)

Connecticut Pulmonary Specialists, PC is a pulmonary disease physician provider located in New Haven, 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	Connecticut Pulmonary Specialists, PC
Address	46 Prince St
City	New Haven
State	CT
ZIP	06519
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	April 7, 2011

Payer Source	Total Paid
Medicaid	$2.3M
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
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…	17,490	$50	$857K
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,…	1,650	$290	$478.2K
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…	2,650	$100	$259.5K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	600	$300	$178.5K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	6,050	$20	$90.8K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	1,950	$40	$78.1K
94727	The provider performs a pulmonary function test, or PFT, to assess the patient’s lung volumes using gas dilution or washout techniques that compare a known concentration of an inhaled gas with the…	5,760	$10	$69.1K
94660	The provider initiates continuous positive airway pressure ventilation, or CPAP, typically for a patient with sleep apnea, or periodic cessation of breathing while asleep. He trains the patient on…	5,730	$10	$63K
94010	The provider or technician administers a spirometry test to assess the patient's respiratory function. The spirometer is attached to a computer that records the total and timed vital capacity…	5,740	$10	$51.7K
99401	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	2,050	$20	$43K

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

Connecticut Pulmonary Specialists, PC — 4 of 23 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
J2357	Injection, omalizumab, 5 mg	4	10	470	$830	$1.1M
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,…	14	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…	68	80	790	$240	$650K
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…	104	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…	880	1,710	750	$30	$243.3K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	11	40	210	$510	$241.3K
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…	38	100	340	$30	$172.2K
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…	43	480	150	$90	$100.9K
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…	373	380	220	$70	$99.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	181	200	530	$20	$69.3K

Showing 1–10 of 25

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cornell Scott Hill Health Corporation	CT	Federally Qualified Health Center (FQHC)	$338.5K	$294.2M
Apt Foundation, Inc	CT	Methadone Clinic	$0	$28.6M
Yale Univ School Of Medicine	CT	Adolescent and Children Mental Health Clinic/Center	$0	$13.2M
New Haven Board Of Education	CT	Local Education Agency (LEA)	$0	$12.2M
Connecticut Retina Consultants LLC	CT	Ophthalmology Physician	$0	$8.3M
Continuum Of Care, Inc.	CT	Adult Mental Health Clinic/Center	$0	$4.9M
Wayne Larrison	CT	Ophthalmology Physician	$1.9M	$0
Rachel Collins	CT	Professional Counselor	$0	$1.7M
James Weisz	CT	Ophthalmology Physician	$1.3M	$0
Amir Cohen	CT	Ophthalmology Physician	$1.1M	$0

Connecticut Pulmonary Specialists, PC — Billing Profile & Reimbursement Data

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Connecticut Pulmonary Specialists, 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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