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 Ohio for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Ohio 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. Ohio (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.

Prime Healthcare Foundation - Coshocton, LLC (NPI 1013468172)

Prime Healthcare Foundation - Coshocton, LLC is a general acute care hospital provider located in Coshocton, Ohio. This profile covers 0 Medicare and 181 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	Prime Healthcare Foundation - Coshocton, LLC
Address	1460 Orange St
City	Coshocton
State	OH
ZIP	43812
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 24, 2016

Payer Source	Total Paid
Medicaid	$13.3M
Medicare	$0

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

181 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	21,390	$80	$1.7M
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.	19,110	$90	$1.7M
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.	12,430	$120	$1.5M
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.	15,210	$90	$1.4M
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…	34,640	$40	$1.4M
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…	29,290	$40	$1.1M
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.	4,580	$230	$1.1M
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…	4,810	$90	$428.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	5,020	$80	$376.4K
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.	1,240	$190	$237.7K

Showing 1–10 of 181

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.

Claims Volume vs. Ohio Distribution

Prime Healthcare Foundation - Coshocton, LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

181 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	37	150	4,030	$100	$5.9M
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.	84	170	4,660	$300	$2.6M
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.	149	480	4,510	$90	$1.8M
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.	155	660	460	$90	$1.5M
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.	125	580	510	$100	$1.3M
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…	30	140	1,130	$90	$1.1M
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.	152	290	1,380	$90	$635.2K
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.	148	280	1,110	$110	$605.7K
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.	182	230	2,200	$100	$530.1K
G0378	Hospital observation service, per hour	134	160	2,840	$80	$529.2K

Showing 1–10 of 181

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prime Healthcare Foundation - Southern Regional, LLC	GA	General Acute Care Hospital	$0	$25.9M
Meisam Moghbelli	WI	Cardiovascular Disease Physician	$290K	$0
Larry Todd	OH	Orthopaedic Surgery of the Spine Physician	$233.1K	$0
Mark Gittins	OH	Orthopaedic Surgery Physician	$206.6K	$0
Duane Pool	OH	Cardiovascular Disease Physician	$165.4K	$0
Scott Stephens	OH	Orthopaedic Surgery Physician	$162K	$0
Michael Woolery	OH	Family Medicine Physician	$123.6K	$0
Douglas Yoder	OH	Surgery Physician	$98.5K	$0
Keith Harmon	KY	Surgery Physician	$73.7K	$0
Haval Saadlla	OH	Pulmonary Disease Physician	$64.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
County Of Coshocton	OH	Land Ambulance	$436.1K	$914.3K
Ahmed Habib	OH	Cardiovascular Disease Physician	$61K	$0
Mary Lynne Garrett	OH	Nurse Practitioner	$39.3K	$0
David Erwin	OH	Optometrist	$10.5K	$0
Betty Gwinn-hall	OH	Women's Health Nurse Practitioner	$9.8K	$0

Prime Healthcare Foundation - Coshocton, LLC — Billing Profile & Reimbursement Data

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Prime Healthcare Foundation - Coshocton, LLC — 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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