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

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

Riverside Hospital Inc. (NPI 1043353956)

Riverside Hospital Inc. is a family medicine physician provider located in Newport News, Virginia. This profile covers 0 Medicare and 100 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	Riverside Hospital Inc.
Address	856 J Clyde Morris Blvd
City	Newport News
State	VA
ZIP	23601
Taxonomy	Family Medicine Physician
NPI Enumerated	February 14, 2007

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

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

100 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	62,410	$50	$3.1M
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…	22,730	$70	$1.5M
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…	7,750	$70	$565.8K
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…	6,990	$80	$545.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	4,180	$80	$317.4K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	1,480	$80	$121K
99381	The provider performs a well–baby visit for a child under the age of one.	1,970	$60	$112.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	8,560	$10	$111.3K
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,…	3,270	$30	$111.2K
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	5,960	$20	$107.3K

Showing 1–10 of 100

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Riverside Hospital Inc. — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

100 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	105	3,520	370	$70	$280.7K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	66	130	340	$110	$210.5K
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…	32	4,010	290	$50	$199.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	293	400	370	$30	$162.2K
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…	37	650	150	$80	$115.4K
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…	26	580	150	$70	$109K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	183	210	390	$50	$106.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	271	280	140	$80	$105K
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…	425	970	100	$100	$87.1K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	152	210	350	$80	$84K

Showing 1–10 of 100

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Riverside Hospital Inc	VA	General Acute Care Hospital	$0	$136.7M
Riverside Physician Services, Inc.	VA	Family Medicine Physician	$0	$44.7M
Shore Health Services Inc.	VA	Rural Acute Care Hospital	$0	$24.7M
Riverside Middle Peninsula Hospital Inc	VA	General Acute Care Hospital	$0	$19M
Riverside Physician Services Inc	VA	Emergency Medicine Physician	$0	$17.3M
Michumi PLLC	VA	Emergency Medicine Physician	$0	$12.4M
Doctors' Hospital Of Williamsburg	VA	General Acute Care Hospital	$0	$12M
Matthew Reed	VA	Ophthalmology Physician	$4.6M	$0
Brian Keel	VA	Ophthalmology Physician	$2.7M	$0
Anthony Farah	VA	Ophthalmology Physician	$653.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope In Home Care LLC	VA	Respite Care	$0	$63.4M
New Life, LLC	VA	Community/Behavioral Health Agency	$0	$10.6M
All Ways There Home Care	VA	Home Health Agency	$0	$9.4M
Universal Mental Health Services, LLC	VA	Adolescent and Children Mental Health Clinic/Center	$0	$7.1M
Peninsula Radiological Associates Limited	VA	Diagnostic Radiology Physician	$0	$6.5M
Charles Kersh	VA	Radiation Oncology Physician	$408.8K	$0
Michael Hooker	VA	Orthopaedic Surgery Physician	$382.5K	$0
Brian Holloway	VA	Student in an Organized Health Care Education/Training Program	$377.4K	$0
Huy Tran	VA	Internal Medicine Physician	$374.4K	$0
Dean Kostov	VA	Neurological Surgery Physician	$304.4K	$0

Riverside Hospital Inc. — Billing Profile & Reimbursement Data

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Riverside Hospital 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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