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

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

Shawnee Mission Medical Center Inc (NPI 1023171634)

Shawnee Mission Medical Center Inc is a general acute care hospital provider located in Merriam, Kansas. This profile covers 0 Medicare and 118 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	Shawnee Mission Medical Center Inc
Address	9100 W 74th St
City	Merriam
State	KS
ZIP	66204
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 18, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

118 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	7,160	$50	$329.5K
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.	5,870	$50	$305.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	11,900	$10	$107.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	5,430	$10	$65.2K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	840	$70	$59.8K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	300	$100	$28.8K
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.	390	$60	$23.2K
G0378	Hospital observation service, per hour	960	$20	$22K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	910	$20	$20.9K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	440	$40	$17.2K

Showing 1–10 of 118

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kansas Distribution

Shawnee Mission Medical Center Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kansas

Full comparison — all codes billed, vs. Kansas median

118 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	37	50	300	$60	$648.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	37	60	280	$30	$295.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	37	60	230	$30	$292K
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	200	260	$60	$216K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	267	290	1,600	$40	$214.2K
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.	52	110	320	$60	$205K
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.	30	270	310	$50	$184.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	25	40	280	$40	$160.9K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	226	230	2,530	$20	$157.2K
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…	9	10	770	$70	$132.3K

Showing 1–10 of 118

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shawnee Mission Medical Center, Inc.	KS	Urgent Care Clinic/Center	$0	$674.4K
Piyushkumar Jani	KS	Psychiatry Physician	$28.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Anthem Overland Park Management, LLC	KS	Adult Care Home Facility	$0	$10.7M
Heartland Inc	KS	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.5M
Alliance Radiology, PA	KS	Diagnostic Radiology Physician	$0	$2.3M
The Behavior Project LLC	KS	Behavior Analyst	$0	$2M
Health Partnership Clinic, Inc	KS	Federally Qualified Health Center (FQHC)	$0	$1.8M
Kansas City Surgery Center, LLC	KS	Ambulatory Surgical Clinic/Center	$1.2M	$0
Deborah A King Ma & Associates Inc	KS	Speech-Language Pathologist	$0	$961.3K
Em Specialists PA	KS	Emergency Medicine Physician	$0	$876.5K
Shawnee Mission Surgery Center LLC	KS	Ambulatory Surgical Clinic/Center	$800.2K	$0
Ascentist Asc Merriam, LLC	KS	Ambulatory Surgical Clinic/Center	$366.7K	$96.1K

Shawnee Mission Medical Center Inc — Billing Profile & Reimbursement Data

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Shawnee Mission Medical Center Inc — 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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