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

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

Norton Hospitals Inc (NPI 1043348808)

Field	Value
Entity Type	Organization
Organization	Norton Hospitals Inc
Address	234 E Gray St
City	Louisville
State	KY
ZIP	40202
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$419.8M
Medicare	$0

Key Findings

The provider is effectively a Medicaid-focused hospital: there is no Medicare billing on file and total Medicaid revenue is reported as $419.8M, indicating a single-payer concentration in Medicaid for the periods covered. This payer mix implies Medicaid policy and rate changes will have outsized budgetary impact on the provider compared with any Medicare exposure, which appears absent in the available data.

Revenue is highly concentrated in emergency department E/M services: the top three Medicaid codes (99284, 99283, 99285) together account for 47.2% of the provider’s total Medicaid revenue. Individually those codes are 99284 ($53.7M revenue, 22.4%), 99283 ($40.5M revenue, 16.9%), and 99285 ($19.1M revenue, 7.9%), which signals that a large share of revenue is driven by ED throughput and high-volume urgent/emergent care encounters.

The mix of high-volume E/M and observation codes points to an operational model built around emergency and short-stay care: 99284 has 172.2K claims, 99283 has 181.7K claims, and observation service G0378 shows 52.7K claims with $8.2M revenue. Coupled with 99282 (57.4K claims, $11.5M revenue), these data suggest substantial ED visit volume feeding observation and short inpatient stays rather than elective inpatient procedures.

High volumes of IV administration and fluid/infusion codes indicate heavy inpatient/ED therapeutic throughput and infusion services: 96374 (136K claims, $3.5M revenue), 96365 (75.8K claims, $3.6M revenue), 96375 (74.6K claims, $4.6M revenue), and 96361 (93.9K claims, $3.2M revenue) are all present at extreme or top percentile state volumes. These patterns are consistent with sustained demand for IV treatments, hydration, and sequential infusions supporting both acute care and infusion clinic activity.

Advanced imaging and diagnostic capacity is a clear service line: CT abdomen/pelvis 74177 accounts for $12M revenue (31.9K claims), CT head 70450 is $7.1M (35.8K claims), and multiple MRI codes (70551 $5.9M, 72148 $5.8M, 70553 $5.5M) rank at or near the top statewide. The presence of PET/CT 78815 ($3.9M) and high-rank MRI/CT activity indicates significant radiology throughput and capability to support complex diagnostics and cancer staging.

Oncology, radiation, and implantable device services contribute meaningful Medicaid revenue and diversify the service mix: J9271 (pembrolizumab) is $7.3M, J1745 (infliximab) is $4.6M, 77386 (IMRT) is $3.3M, and implant codes C1776 ($7.5M) and C1713 ($7.2M) are material contributors. These entries show the hospital not only manages acute ED demand but also has specialty oncology and surgical implant volumes that add to total revenue.

Competitive standing within Kentucky is strong and often dominant: several top codes rank at the very top statewide—examples include 99282 (#1 of 158, 100th percentile), 99283 (#2 of 284, 100th percentile; labeled an extreme outlier), 70551 (#1 of 87, 100th percentile), 72148 (#1 of 136, 100th percentile), and multiple infusion and administration codes that are #1 and 100th percentile. Many other codes (e.g., 99284 rank #3 of 282, 99th percentile; G0378 rank #2 of 87, 99th percentile) are described as "notably above typical state volume" or "extreme outlier," underscoring the provider’s role as a major in-state volume leader across ED, imaging, and infusion services.

The provider is long-established in claims records, with NPI enumerated on 2007-03-01 (~19 years ago), which aligns with the scale and breadth of services seen in Medicaid billing. Longevity plus the concentrated Medicaid footprint and repeated top-state rankings suggest a stable, high-throughput acute-care operation that will be highly sensitive to Medicaid reimbursement and policy shifts.

Medicaid: Complete Services Breakdown

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

892 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.	172,180	$310	$53.7M
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.	181,710	$220	$40.5M
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.	64,360	$300	$19.1M
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.	31,950	$380	$12M
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.	57,390	$200	$11.5M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	19,340	$480	$9.3M
G0378	Hospital observation service, per hour	52,670	$160	$8.2M
C1776	Joint device (implantable)	780	$9,610	$7.5M
J9271	Injection, pembrolizumab, 1 mg	1,350	$5,430	$7.3M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	5,300	$1,360	$7.2M

Showing 1–10 of 892

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Norton Hospitals Inc — 19 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

892 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	3	10	810	$7,760	$8.7M
J9299	Injection, nivolumab, 1 mg	3	10	540	$6,390	$4M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	62	310	830	$120	$3.7M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	2	10	4,350	$560	$3.3M
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	280	7,150	$150	$3M
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.	10	240	4,710	$150	$2.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	2	10	140	$3,650	$2.5M
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.	2	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	11	40	740	$1,170	$1.7M
J3380	Injection, vedolizumab, intravenous, 1 mg	2	10	110	$5,930	$1.6M

Showing 1–10 of 892

Related Providers

Other providers that share a Tax Identification Number (TIN) with Norton Hospitals Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton Hospitals, Inc	KY	General Acute Care Hospital	$0	$299.3M
Norton Hospitals Inc	KY	Multi-Specialty Clinic/Center	$0	$3.4M
Norton Hospitals Inc	KY	Land Ambulance	$791.2K	$77.1K
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0
Aaron Spalding	KY	Radiation Oncology Physician	$227.5K	$0
Joseph Maly	KY	Hematology & Oncology Physician	$164.3K	$0
Yong Cha	KY	Radiation Oncology Physician	$153.8K	$0
Nadeem Usmani	KY	Pain Medicine (Anesthesiology) Physician	$151.6K	$0
Sarah Parsons	KY	Psychiatry Physician	$151.4K	$0
Basel Altoos	KY	Radiation Oncology Physician	$137.2K	$0

Nearby Providers

Other providers in the same ZIP code as Norton Hospitals Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uofl Health-louisville Inc	KY	General Acute Care Hospital	$0	$283.3M
University Medical Center, Inc	KY	General Acute Care Hospital	$0	$179.5M
Verralab Ja LLC	KY	Clinical Medical Laboratory	$304.7K	$38.8M
University Medical Associates	KY	Internal Medicine Physician	$0	$17.3M
Ocean Behavioral Healthcare LLC	KY	Clinical Social Worker	$0	$11.9M
University Emergency Medicine Associates P.s.c.	KY	Emergency Medicine Physician	$0	$11.8M
Recovery Chestnut, LLC	KY	Addiction (Substance Use Disorder) Counselor	$0	$10.9M
Green House Recovery And Rehabilitation Center	KY	Multi-Specialty Clinic/Center	$0	$10.6M
University Of Louisville	KY	General Practice Dentistry	$0	$8.3M
Pediatric And Adult Prompt Care LLC	KY	Pediatrics Physician	$0	$6.9M

Norton Hospitals 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