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

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

University Hospitals Cleveland Medical Center (NPI 1043397292)

Field	Value
Entity Type	Organization
Organization	University Hospitals Cleveland Medical Center
Address	11100 Euclid Ave
City	Cleveland
State	OH
ZIP	44106
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$156.9M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available dataset: there is no Medicare billing on file while Medicaid revenue is reported at $156.9M. The absence of Medicare activity means analysis and contracting considerations should focus on Medicaid flows and utilization rather than dual-payer dynamics.

Revenue concentration within Medicaid is substantial: the precomputed top three Medicaid codes (J9271, 99283, 99214) account for 36.8% of the provider's total Medicaid revenue. Individually, J9271 represents $14.6M and 13.3% of Medicaid revenue, 99283 represents $13M and 11.9%, and 99214 represents $12.8M and 11.6%, indicating a narrow set of high-impact codes drive a large share of dollars.

Clinical mix shows a significant oncology infusion footprint: J9271 (pembrolizumab) has 1.9K claims and $14.6M revenue and ranks #1 of 22 in-state (100th percentile, notably above typical state volume for this code). Supporting chemotherapy and infusion activity is visible in codes such as 96413 (12.5K claims, $1.8M) and 96365/96366 (10.1K/5K claims), which together point to a developed ambulatory infusion/oncology service line rather than isolated drug administration.

Emergency department and outpatient evaluation-and-management are major volume drivers: high claim counts and revenue for 99283 (89.3K claims, $13M; 95th percentile), 99284 (67.7K claims, $10.4M; 94th percentile), 99285 (55.7K claims, $8.1M; 95th percentile) and office visit codes 99214 (98.1K claims, $12.8M; 99th percentile), 99213 (71.8K claims, $9.3M; 98th percentile), 99215 (26.2K claims, $3.1M; 99th percentile) indicate very high ED throughput coupled with substantial ambulatory clinic activity. This pattern suggests the hospital operates large-scale emergency and outpatient evaluation services that materially contribute to Medicaid revenue.

Maternal-fetal and obstetric imaging are outsized service lines: 76816 (32.4K claims, $4.5M) ranks #3 of 185 (99th percentile, extreme outlier), 76819 (27.4K claims, $2.5M) ranks #3 of 90 (98th percentile, extreme outlier), and 76801 (9.3K claims, $1.4M) ranks #4 of 161 (98th percentile, extreme outlier). Multiple high-volume fetal ultrasound codes plus 59025 (9.8K claims, $1.7M; 93rd percentile) indicate a large obstetrics/maternal–fetal imaging program that is well above typical state volumes.

The provider offers a broad spectrum of advanced diagnostics and specialty procedures beyond oncology and obstetrics: imaging codes such as 70450 (13.3K claims, $3.8M; 91st percentile) and 74177 (8.1K claims, $1.3M; 86th percentile), radiation delivery 77386 (5.9K claims, $2.2M; 86th percentile), and sleep testing 95810 (2.5K claims, $1.8M; 96th percentile) point to integrated radiology, radiation oncology, and sleep/laboratory services that diversify Medicaid revenue streams.

Competitive standing is strongest in a few niche, high-cost medications and specialty services: the provider is the statewide leader for J9271 (rank #1 of 22, 100th percentile) and ranks in the top percentiles for major outpatient E/M codes (99214 at 99th percentile, 99215 at 99th percentile) as well as key obstetric ultrasound codes (multiple codes at the 98–99th percentiles). These rank/percentile positions indicate the hospital is a dominant or major player in several Medicaid service categories within Ohio, particularly oncology infusion and maternal-fetal imaging.

The organization has an established billing presence: the NPI was enumerated on 2006-11-01 (~20 years ago), indicating long tenure in the market. Combined with its Medicaid concentration and the high-volume specialty lines identified above, this suggests a stable, historically entrenched provider whose contracting and network value will be assessed primarily through its Medicaid service volumes and high-cost drug utilization.

Medicaid: Complete Services Breakdown

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

805 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	1,900	$7,700	$14.6M
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.	89,350	$150	$13M
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…	98,130	$130	$12.8M
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.	67,710	$150	$10.4M
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…	71,780	$130	$9.3M
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.	55,700	$150	$8.1M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	32,380	$140	$4.5M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	14,790	$290	$4.3M
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.	13,280	$290	$3.8M
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…	26,190	$120	$3.1M

Showing 1–10 of 805

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

University Hospitals Cleveland Medical Center — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

805 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	26	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	1	20	360	$8,480	$5M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	31	170	4,660	$300	$2.6M
J9299	Injection, nivolumab, 1 mg	3	10	210	$6,940	$2.1M
J9144	Injection, daratumumab, 10 mg and hyaluronidase‑fihj	3	10	280	$5,660	$2M
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.	27	480	4,510	$90	$1.8M
H2019	Therapeutic behavioral services, per 15 minutes	304	840	240	$90	$1.8M
J0741	Injection, cabotegravir and rilpivirine, 2mg/3mg	5	10	230	$4,830	$1.7M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	9	10	890	$1,920	$1.7M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	3	20	480	$730	$1.6M

Showing 1–10 of 805

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Hospitals Cleveland Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Hospitals Cleveland Medical Center	OH	Children's Hospital	$0	$76.7M
University Hospitals St. John Medical Center	OH	General Acute Care Hospital	$0	$11.8M
David Smullen	WI	Diagnostic Radiology Physician	$75.5K	$0
Patricia Rudler	OH	Acute Care Nurse Practitioner	$74.6K	$0
Jennifer Root	OH	Acute Care Nurse Practitioner	$36.4K	$5.1K
Paula Ogrocki	OH	Clinical Neuropsychologist	$12K	$0
Jennifer Legros	OH	Adult Health Nurse Practitioner	$10.8K	$0
Jiayi Tao	OH	Physician Assistant	$6.1K	$0
Jacquelyn Mccloskey	OH	Physician Assistant	$4.3K	$0
Mario Manacci	OH	Acute Care Nurse Practitioner	$4.3K	$0

Nearby Providers

Other providers in the same ZIP code as University Hospitals Cleveland Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Hospitals Medical Group Inc	OH	Multi-Specialty Clinic/Center	$0	$107.5M
University Hospitals Laboratory Services Foundation	OH	Clinical Medical Laboratory	$8.4M	$41.1M
Circle Health Services	OH	Federally Qualified Health Center (FQHC)	$0	$7.1M
Community Dialysis Center	OH	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7M
Adir Ludin	OH	Radiation Oncology Physician	$1.6M	$0
Katarzyna Brodowska	OH	Ophthalmology Physician	$929.6K	$162.9K
Eric Palfreyman	OH	Internal Medicine Physician	$1M	$0
Shree Kurup	OH	Ophthalmology Physician	$533.2K	$0
Roy Raad	OH	Diagnostic Radiology Physician	$459.2K	$46.8K
Ari Konheim	OH	Dermatology Physician	$441K	$0

University Hospitals Cleveland Medical Center — 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