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 1972563138)

Middlesex Hospital is a family nurse practitioner provider located in Middletown, Connecticut. This profile covers 0 Medicare and 41 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	80 S Main St
City	Middletown
State	CT
ZIP	06457
Taxonomy	Family Nurse Practitioner
NPI Enumerated	March 23, 2006

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	33,830	$70	$2.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	28,840	$50	$1.4M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	43,660	$30	$1.3M
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…	20,150	$40	$806.2K
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…	19,110	$20	$382.2K
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…	23,080	$10	$323.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,560	$40	$191.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	7,800	$20	$171.5K
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…	2,500	$50	$119.8K
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…	3,640	$30	$109.1K

Showing 1–10 of 41

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 — 0 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	26	130	520	$330	$5.9M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	33	130	690	$180	$4.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	27	110	1,520	$140	$3.4M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	35	60	3,070	$100	$907.8K
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,…	27	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…	35	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…	93	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…	423	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.	26	40	210	$510	$241.3K
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…	14	170	260	$20	$183.2K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Middlesex Hospital	CT	General Acute Care Hospital	$0	$116.1M
Middlesex Hospital	CT	Land Ambulance	$1.4M	$2M
Middlesex Hospital	CT	Home Health Agency	$0	$2.9M
Middlesex Hospital	CT	Family Medicine Physician	$0	$2.7M
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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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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