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

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

The Memorial Hospital (NPI 1063418424)

The Memorial Hospital is a critical access hospital provider located in Craig, Colorado. This profile covers 0 Medicare and 97 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	The Memorial Hospital
Address	750 Hospital Loop
City	Craig
State	CO
ZIP	81625
Taxonomy	Critical Access Hospital
NPI Enumerated	June 21, 2005

Payer Source	Total Paid
Medicaid	$18.8M
Medicare	$0

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

97 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…	30,950	$330	$10.1M
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…	10,850	$290	$3.1M
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.	13,840	$150	$2M
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,…	2,810	$280	$782.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,450	$180	$606.5K
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.	3,010	$150	$448.6K
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.	3,630	$90	$334.2K
99203	The provider sees a new 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 provider…	670	$290	$190.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	950	$150	$144.7K
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…	360	$340	$124.5K

Showing 1–10 of 97

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

The Memorial Hospital — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

97 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	16	20	940	$1,150	$1.5M
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.	124	210	730	$120	$966.7K
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.	47	290	1,390	$110	$958.7K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	95	130	750	$140	$957.7K
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.	104	270	1,290	$100	$937.1K
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.	48	70	410	$250	$881.6K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	91	120	700	$120	$843.2K
A0425	Ground mileage, per statute mile	171	280	990	$20	$636.8K
S5161	Emergency response system; service fee, per month (excludes installation and testing)	27	50	3,160	$40	$382.1K
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…	64	2,520	330	$100	$352K

Showing 1–10 of 97

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kolby Lance	UT	Pediatric Dentistry	$0	$992.1K
John Sielatycki	CO	Orthopaedic Surgery of the Spine Physician	$300.2K	$0
William Howarth	CO	Orthopaedic Surgery Physician	$296.3K	$0
Leo Simpson	TX	Advanced Heart Failure and Transplant Cardiology Physician	$193.1K	$0
John Abboud	CO	Cardiovascular Disease Physician	$190.7K	$0
Alexander Meininger	CO	Sports Medicine (Orthopaedic Surgery) Physician	$164K	$0
Frank Laws	CO	Interventional Cardiology Physician	$150.5K	$0
Lynn Sloan	CO	Physical Medicine & Rehabilitation Physician	$124.4K	$0
Andrew Morse	CO	Surgery Physician	$118.5K	$2.2K
Bartlomiej Lipko	CO	Physician Assistant	$101.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Colorado Visting Nurse Association	CO	Federally Qualified Health Center (FQHC)	$0	$5.6M
Northwest Colorado Visiting Nurse Association	CO	Federally Qualified Health Center (FQHC)	$0	$3.6M
Craig Eckroth	CO	Optometrist	$67.3K	$0
Jessica Nyquist	CO	Physician Assistant	$23K	$0
Craig Rummel	CO	Chiropractor	$14.1K	$0

The Memorial Hospital — Billing Profile & Reimbursement Data

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The Memorial Hospital — 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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