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

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

Winston County Medical Foundation (NPI 1073597126)

Winston County Medical Foundation is a general acute care hospital provider located in Louisville, Mississippi. This profile covers 0 Medicare and 108 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	Winston County Medical Foundation
Address	17550 E Main St
City	Louisville
State	MS
ZIP	39339
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 2, 2005

Payer Source	Total Paid
Medicaid	$7.5M
Medicare	$0

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

108 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	18,740	$120	$2.2M
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.	7,250	$140	$1M
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	6,770	$60	$413.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	13,580	$30	$393.7K
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.	2,300	$170	$389K
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.	3,240	$80	$252.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	8,450	$30	$244.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,370	$60	$205.4K
G0378	Hospital observation service, per hour	830	$210	$178K
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…	3,190	$50	$159.7K

Showing 1–10 of 108

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Winston County Medical Foundation — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

108 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	45	70	1,480	$370	$1.4M
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.	85	230	3,260	$120	$1.4M
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.	52	220	5,690	$100	$1.2M
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.	95	180	3,000	$140	$1.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	51	90	4,540	$90	$665.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	46	90	2,110	$80	$325.8K
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.	77	110	1,250	$110	$311.6K
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…	93	220	1,590	$50	$291.3K
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.	58	150	2,200	$70	$280.7K
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.	42	90	2,310	$50	$220.5K

Showing 1–10 of 108

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Ellis	MN	Specialist	$337.9K	$0
John Roberts	NC	Diagnostic Radiology Physician	$337.2K	$0
William Henson	MS	Diagnostic Radiology Physician	$335.5K	$0
Richard Arriola	MS	Diagnostic Radiology Physician	$326.9K	$0
Sarah Deraney	KY	Diagnostic Radiology Physician	$302.4K	$0
Edward Giaroli	MS	Diagnostic Radiology Physician	$277.2K	$0
Vernon Barrow	MS	Diagnostic Radiology Physician	$269.6K	$0
Jeffrey Howard	MS	Diagnostic Radiology Physician	$268.1K	$0
Keith Andrews	TN	Diagnostic Radiology Physician	$267K	$0
Mary Moss	MS	Diagnostic Radiology Physician	$259.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Drayer Physical Therapy Mississippi LLC	MS	Physical Therapist	$0	$13.3M
William Mcreynolds	MS	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$3.4M
Rcg Mississippi, Inc.	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.3M
Vital Health Care & Associates Inc.	MS	Community Based Hospice Care Agency	$0	$1.6M
Choctaw Regional Medical Center	MS	Rural Health Clinic/Center	$0	$1.6M
Winston Medical Clinic LLC	MS	Rural Health Clinic/Center	$0	$1.4M
Diamond Grove Center	MS	Psychiatric Hospital	$0	$1.3M
Danny Clifton	MS	Optometrist	$27.2K	$333.5K
Adam Byrd	MS	Dermatology Physician	$169.5K	$0
Carmen Byrd	MS	Family Nurse Practitioner	$167K	$0

Winston County Medical Foundation — Billing Profile & Reimbursement Data

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Winston County Medical Foundation — 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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