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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Wentworth Douglass Hospital (NPI 1033118104)

Key Findings

Field	Value
Entity Type	Organization
Organization	Wentworth Douglass Hospital
Address	789 Central Avenue
City	Dover
State	NH
ZIP	03820
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 20, 2005

Payer Source	Total Paid
Medicaid	$30.6M
Medicare	$0

This provider is effectively single-payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $30.6M, indicating the provider’s reported activity in this dataset is concentrated in Medicaid rather than Medicare. Analysts should treat any Medicare-based competitive or utilization benchmarking as not applicable for this facility given the absence of Medicare claims on file.

Revenue is highly concentrated in a small set of Medicaid codes: the top three Medicaid codes by revenue account for 40.9% of total Medicaid revenue, driven by 99284 ($4.5M, 20.0%), 99283 ($2.5M, 11.2%), and 74177 ($2.2M, 9.7%). This concentration signals that a few high-volume ED and advanced imaging services dominate the provider’s Medicaid revenue base.

The overall code mix indicates a high-volume emergency department and observation footprint: 99284 appears with 21.8K claims ($4.5M), 99283 with 21.9K claims ($2.5M), and 99285 with 6.4K claims ($1.7M), while G0378 (hospital observation service) contributes ~$1M. High counts for ED E/M codes plus observation hours and frequent IV/infusion codes (96374, 96361, 96365) point to a clinical model oriented around acute care, ED throughput, and short-term observation/infusion management.

Imaging and diagnostics are prominent revenue drivers alongside ED activity: 74177 (CT abdomen/pelvis with contrast) yields $2.2M from 4.9K claims, 70450 (CT head without contrast) yields $1M from 5.3K claims, and 71260 (CT thorax with contrast) contributes $382.7K. The presence of both high-volume CT and MRI codes (70553) supports the interpretation that the hospital maintains substantial on-site diagnostic imaging capacity tied closely to its ED caseload.

Competitive standing in-state is strong on several core codes: 99283 ranks #4 of 66 (95th percentile) and 99284 ranks #6 of 76 (93th percentile), while 74177 ranks #4 of 47 (93th percentile). These rank/percentile positions indicate the provider is a major regional participant for emergency E/M and certain CT services relative to other in-state facilities, rather than a marginal operator for those lines of service.

This site is an extreme outlier for COVID testing and specimen collection volume in Medicaid: U0003 (SARS-CoV-2 amplified probe) has 21.1K claims and ranks #1 of 36 (100th percentile; extreme outlier), G2023 ranks #1 of 39 (100th percentile; extreme outlier), and U0005 ranks #1 of 22 (100th percentile; extreme outlier). These patterns reflect historically very high testing throughput compared with peers and materially contributed to Medicaid revenue in the pandemic period.

Outpatient ancillary and rehabilitation services show significant volume breadth: 97110 (therapeutic exercise) posts 28K claims ($756.1K, 3.3% of revenue) and 97140 (manual therapy) posts 16.2K claims ($292.4K), while low-level outpatient E/M 99212 appears with 26.1K claims ($809.7K) and ranks #2 of 106 (99th percentile). This suggests the provider operates a sizable outpatient therapy and minor E/M footprint alongside its acute/ED activity, capturing diverse Medicaid service lines beyond imaging and ED.

The provider is an established entity with long tenure: NPI enumerated 2005-07-20 (~21 years ago). Combined with its Medicaid-centric billing profile and the mix of high-volume ED, observation, imaging, testing, infusion, and therapy codes, the tenure supports interpretation of an entrenched community acute-care hospital with strong Medicaid utilization patterns rather than a newly formed or transient operation.

Medicaid: Complete Services Breakdown

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

328 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	21,820	$210	$4.5M
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.	21,890	$120	$2.5M
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.	4,870	$450	$2.2M
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.	6,370	$270	$1.7M
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…	21,110	$60	$1.3M
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.	5,270	$190	$1M
G0378	Hospital observation service, per hour	5,470	$180	$1M
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,…	26,120	$30	$809.7K
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…	28,010	$30	$756.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	18,880	$30	$622.9K

Showing 1–10 of 328

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Wentworth Douglass Hospital — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

328 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.	15	60	1,820	$150	$756.5K
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.	6	80	2,220	$120	$745.6K
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.	4	70	2,540	$110	$733.8K
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	50	1,150	$230	$480.4K
G0378	Hospital observation service, per hour	4	20	1,390	$190	$406.3K
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)…	12	10	450	$120	$403.9K
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.	5	50	1,250	$90	$224K
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.	8	50	2,010	$80	$209.6K
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.	8	50	1,240	$40	$195.1K
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…	5	130	1,320	$40	$184.3K

Showing 1–10 of 328

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wentworth Douglass Physician Corporation	NH	Magnetic Resonance Imaging Radiologic Technologist	$0	$2.7M
Alison Sollee	NH	Internal Medicine Physician	$93.7K	$0
Benjamin Lowenstein	ME	Cardiovascular Disease Physician	$51K	$0
Lisa Burke	NH	Occupational Therapist	$28.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Behavioral Health And Developmental Services Of Strafford County, Inc	NH	Case Management Agency	$0	$169.8M
Living Innovations Support Services, LLC	NH	Developmentally Disabled Services Day Training Agency	$0	$147.3M
Living Innovations Support Services, LLC	NH	Developmentally Disabled Services Day Training Agency	$0	$129.3M
Work Opportunities Unlimited Contracts, Inc.	NH	Developmentally Disabled Services Day Training Agency	$0	$17.9M
Living Innovations Support Services, LLC	NH	Community/Behavioral Health Agency	$0	$11.2M
Work Opportunities Unlimited Contracts, Inc.	NH	Developmentally Disabled Services Day Training Agency	$0	$8.4M
Behavioral Health And Developmental Services Of Strafford County, Inc	NH	Early Intervention Provider Agency	$0	$5M
Seacoast Emergency Physicians, PC	NH	Emergency Medical Services (Emergency Medicine) Physician	$0	$4.5M
Southeastern New Hampshire Alcohol And Drug Abuse Services	NH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$3.7M
Reach For The Top Therapy Services	NH	Occupational Therapist	$0	$2.7M

Wentworth Douglass Hospital — 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