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

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

Bellin Memorial Hospital Inc (NPI 1033172390)

Key Findings

Field	Value
Entity Type	Organization
Organization	Bellin Memorial Hospital Inc
Address	744 S Webster Ave
City	Green Bay
State	WI
ZIP	54301
Taxonomy	Family Medicine Physician
NPI Enumerated	April 8, 2006

Payer Source	Total Paid
Medicaid	$19.8M
Medicare	$0

This provider reports no Medicare billing on file and $19.8M in lifetime Medicaid revenue, making its financial footprint effectively single‑payer and heavily concentrated in Medicaid. Analysts should treat Medicaid reimbursement policy and network relationships as the primary drivers of this entity’s revenue exposure and competitive positioning.

Revenue concentration is high: the precomputed top three Medicaid codes (99214, 99213, J0585) account for 69.5% of total Medicaid revenue. Those three codes individually contribute $4.7M (29.2%), $3.3M (20.5%), and $3.2M (19.8%) respectively, indicating a revenue profile dominated by a small set of high‑volume services.

The CPT mix signals a large ambulatory primary‑care and outpatient evaluation operation: 99214 shows 98.8K claims and $4.7M revenue and 99213 shows 90.2K claims and $3.3M revenue, reflecting extremely high volumes of established‑patient office visits. Presence of other E/M codes (99215, 99204, 99203) and well‑visit pediatric/adult codes (99391–99396 series) supports a broad primary care and preventive services footprint rather than a narrowly specialized clinic.

J0585 (injection, onabotulinumtoxina) is a material non‑E/M revenue stream with 6.8K claims and $3.2M revenue, ranking #2 of 32 in‑state (97th percentile, notably above typical state volume). This indicates a significant line of therapeutic injection activity—consistent with high‑volume botulinum toxin treatment—representing a specialized service line that materially diversifies income away from office visits.

Competitive standing on core E/M codes is dominant statewide: 99214 ranks #15 of 1628 providers in‑state and 99213 ranks #19 of 1755 providers (both 99th percentile, labeled extreme outliers). These ranks identify the provider as a major volume outlier for routine outpatient E/M services in Wisconsin and imply strong market share or a system‑level role in serving Medicaid populations for primary care encounters.

Several ancillary and diagnostic codes also show above‑typical volumes and suggest integrated outpatient capabilities: 87426 (SARS‑CoV‑2 immunoassay) has 7.9K claims and ranks #3 of 76 (97th percentile), 87880 (strep test) has 10.1K claims and ranks #8 of 285 (98th percentile, extreme outlier), and 80053 has 23.9K claims. Together these data point to a high throughput clinic with on‑site testing capacity and busy laboratory services supporting ambulatory care.

Other notable service lines include therapeutic and rehabilitative care and procedure volumes: 97110 (therapeutic exercise) shows 11.7K claims, 90960 (ESRD monthly care) shows 4.9K claims, and 64615 (bilateral chemodenervation) has 3.6K claims and ranks #2 of 28 (96th percentile, notably above typical). These entries indicate the provider bills across rehab, renal chronic care management, and additional injection procedures, suggesting a multi‑disciplinary outpatient platform.

The provider has an NPI enumeration date of 2006‑04‑08 (~20 years ago), denoting long tenure. When combined with the concentrated Medicaid revenue base and the provider’s status as a high‑volume outlier on several in‑state codes, this longevity supports interpretation of the observed patterns as established operational strategy rather than transient activity, but also signals sensitivity to Medicaid policy or network shifts.

Medicaid: Complete Services Breakdown

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

289 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	98,770	$50	$4.7M
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…	90,150	$40	$3.3M
J0585	Injection, onabotulinumtoxina, 1 unit	6,830	$470	$3.2M
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…	4,780	$90	$410.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,630	$70	$365.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	5,640	$60	$349.8K
99204	The provider sees a new 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 provider…	3,850	$90	$334.5K
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.	3,240	$100	$310.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,840	$60	$309.7K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	7,940	$30	$238.2K

Showing 1–10 of 289

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Bellin Memorial Hospital Inc — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

289 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	167	360	1,550	$70	$614.4K
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.	146	430	760	$60	$484.6K
J0585	Injection, onabotulinumtoxina, 1 unit	2	30	550	$240	$428.8K
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	6	30	1,050	$70	$320.9K
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…	138	170	720	$70	$272.7K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	17	20	830	$140	$245.3K
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)…	40	80	650	$110	$244.4K
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.	40	260	3,590	$20	$232.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	20	20	50	$400	$216.3K
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…	21	40	930	$100	$214.5K

Showing 1–10 of 289

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bellin Memorial Hospital Inc.	WI	General Acute Care Hospital	$0	$29.2M
Oconto Hospital & Medical Center Inc	WI	Critical Access Hospital	$0	$4.8M
Oconto Hospital & Medical Center Inc	WI	Rural Health Clinic/Center	$0	$4.2M
Bellin Psychiatric Center Inc.	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.1M
Debbie Lim	WI	Rheumatology Physician	$1.8M	$0
Kevan Lewis	WI	MOHS-Micrographic Surgery Physician	$1.2M	$0
Paul Tuttle	WI	Rheumatology Physician	$861.3K	$0
Riley Smyth	WI	Diagnostic Radiology Physician	$805.1K	$320
Michael Avery	WI	Rheumatology Physician	$681.6K	$0
Terence Ryan	MI	Family Medicine Physician	$441.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Vincent Hospital-hospital Sisters-third Order Of St Francis	WI	General Acute Care Hospital	$0	$19.6M
County Of Brown	WI	Community/Behavioral Health Agency	$0	$12.8M
Hha Of Wisconsin, LLC	WI	Home Health Agency	$0	$5.6M
City Of Green Bay Office Of Comptroller	WI	Land Ambulance	$613K	$3.7M
Cerebral Palsy, Inc.	WI	Rehabilitation Clinic/Center	$0	$4M
Innovative Wisconsin, LLC	WI	Community/Behavioral Health Agency	$0	$3.8M
Almost Family Personal Care, LLC	WI	Nursing Care Agency	$0	$3.1M
Renal Life Link Inc	WI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.8M
St Vincent Hospital-hospital Sisters-third Order Of St Francis	WI	Clinical Medical Laboratory	$0	$2.6M
La Sante Wisconsin Inc.	WI	Durable Medical Equipment & Medical Supplies	$0	$2.3M

Bellin 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