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.

Johnson Memorial Hospital, Inc. (NPI 1972728442)

Key Findings

Field	Value
Entity Type	Organization
Organization	Johnson Memorial Hospital, Inc.
Address	201 Chestnut Hill Rd
City	Stafford Springs
State	CT
ZIP	06076
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 17, 2007

Payer Source	Total Paid
Medicaid	$22.3M
Medicare	$0

This provider is effectively a Medicaid-focused operation: there is no Medicare billing on file while reported Medicaid revenue totals $22.3M, which implies Medicaid is the primary payer driving the facility’s billed services in the available data. The absence of Medicare activity suggests limited Medicare patient volume or non-participation in Medicare billing rather than a mixed payer profile.

Medicaid revenue is highly concentrated in emergency department evaluation-and-management codes: the precomputed top-3 Medicaid codes account for 60.0% of total Medicaid revenue, and those three codes are 99285 ($6M, 28.8%), 99284 ($3.5M, 16.9%), and 99283 ($3M, 14.3%). This concentration indicates the hospital’s Medicaid revenue base is dominated by ED visits at varying levels of acuity.

The code mix signals an acute-care, emergency-centric service line with ancillary inpatient/acute capabilities: high-revenue ED E/M codes (99285, 99284, 99283) sit alongside critical care 99291 ($467.7K) and cross-sectional imaging such as 74177 ($827.5K) and 70450 ($408.5K), consistent with a hospital that provides ED, imaging, and some level of critical care. These non-ED codes together support the interpretation that the facility manages higher-acuity presentations requiring imaging and occasional critical care.

Intravenous therapy and medication administration are a meaningful secondary revenue stream for Medicaid: 96374 ($1.5M, 7.3%) is among the top codes, and related infusion codes 96361 ($386.7K), 96360 ($368.8K), 96375 ($348.5K), and 96365 ($321.7K) appear further down the list, indicating routine IV meds/fluids administration tied to ED or observation workflows rather than elective infusion services. The prominence of these codes aligns with a heavy ED throughput where IV treatments and sequential infusions are commonly delivered.

Rehabilitative services are a notable ancillary line: 97010 ($919.4K, 4.4%) and 97110 ($495.8K, 2.4%) both appear in the top codes, and 97010 ranks #11 of 48 providers in-state (79th percentile) while 97110 ranks #68 of 348 providers in-state (81th percentile). These placements show the hospital has relatively strong standing for simple physical-therapy modalities within the state, suggesting an established on-site therapy program that supplements its ED/inpatient care.

For competitive standing on its primary revenue drivers, the hospital is a modest participant rather than a dominant player: 99285 ranks #40 of 129 providers in-state (70th percentile), 99284 ranks #46 of 127 (64th percentile), and 99283 ranks #41 of 114 (65th percentile), each described in the source data as "typical, unremarkable volume". Those mid-to-upper percentile placements indicate steady ED volumes but not market leadership among Connecticut Medicaid-reporting hospitals.

Other outpatient and diagnostic services show moderate, typical volumes in-state: CT abdomen/pelvis 74177 ($827.5K) ranks #37 of 72 (49th percentile), head CT 70450 ($408.5K) ranks #42 of 80 (48th percentile), and SARS-CoV-2 test U0003 ($256.1K) ranks #23 of 46 (51th percentile). These mid-table ranks underscore that imaging and COVID testing are operationally important but not distinguishing competitive advantages relative to peers.

The provider has a long tenure in the NPI file (NPI enumerated 2007-04-17 (~19 years ago)), indicating an established presence in the community; combined with a Medicaid-dominant revenue base, this profile points to sensitivity to state Medicaid policy and reimbursement shifts. Given the revenue concentration in a small set of ED codes (60.0% from the top three), the facility’s financial exposure is concentrated in emergency care demand and Medicaid payment rates for those services.

Medicaid: Complete Services Breakdown

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

220 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.	14,900	$410	$6M
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.	12,630	$280	$3.5M
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.	14,950	$200	$3M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,140	$140	$1.5M
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	14,830	$60	$919.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	4,620	$180	$827.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8,850	$60	$495.8K
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…	850	$550	$467.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	4,130	$100	$408.5K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	8,590	$50	$386.7K

Showing 1–10 of 220

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

Johnson Memorial Hospital, Inc. — 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

220 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	29	40	21,520	$90	$8M
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.	40	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.	46	130	690	$180	$4.7M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	26	40	23,540	$140	$3.7M
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.	41	110	1,520	$140	$3.4M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	23	30	17,770	$50	$1.1M
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	28	40	1,910	$190	$1.1M
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	23	30	7,070	$130	$1.1M
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	27	40	5,360	$120	$1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	23	50	3,340	$60	$1M

Showing 1–10 of 220

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stafford Public Schools	CT	Local Education Agency (LEA)	$0	$1.1M
Susan Parker	CT	Anatomic Pathology & Clinical Pathology Physician	$48.4K	$0
Brian Fry	CT	Physician Assistant	$43.4K	$0
Dawn Froonjian	CT	Family Nurse Practitioner	$33.1K	$0
Paul Cooke	CT	Anesthesiology Physician	$17.5K	$0

Johnson Memorial Hospital, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References