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.

Miami Valley Hospital (NPI 1073688354)

Field	Value
Entity Type	Organization
Organization	Miami Valley Hospital
Address	1 Wyoming St
City	Dayton
State	OH
ZIP	45409
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 21, 2006

Payer Source	Total Paid
Medicaid	$159M
Medicare	$0

Key Findings

This provider is effectively single-payer in the claims dataset: there is no Medicare billing on file while total Medicaid revenue is $159M. The absence of Medicare activity combined with substantial Medicaid receipts indicates that Medicaid dominates the revenue mix for MIAMI VALLEY HOSPITAL in the available data.

Revenue is highly concentrated in a small set of outpatient/ED and infusion-related codes: the precomputed top 3 Medicaid codes by revenue account for 46.5% of the provider's total Medicaid revenue, driven by 99284 ($22.4M, 175.1K claims, 16.9%), 99283 ($20.5M, 176.5K claims, 15.4%), and 96361 ($18.8M, 64.7K claims, 14.1%). This concentration implies that a large share of the hospital’s Medicaid dollars come from emergency department visits and extended IV fluid administration.

The code mix points to a high-throughput emergency department with substantial observation and infusion services: top ED E/M codes appear at scale (99284, 99283, 99285, 99282) alongside high-volume observation (G0378: 60.6K claims, $3.7M) and IV infusion codes (96361, 96365, 96366). These patterns are consistent with a major acute-care hospital operating a busy ED, observation unit, and infusion/infusion-support workflows.

State-level competitive standing is strong in several categories: 99283 ranks #5 of 484 providers in-state (99th percentile; extreme outlier) and 99284 ranks #12 of 655 (98th percentile; extreme outlier), while 96361 ranks #2 of 165 (99th percentile; extreme outlier). Additional top positions include 0241U at #1 of 88 providers (100th percentile) and A0434 at #1 of 23 providers (100th percentile), indicating dominant or near-dominant volumes in multiple Medicaid code lines within Ohio.

The hospital administers some high-cost specialty drugs but at modest provider counts relative to its ED activity: J2350 (ocrelizumab) accounts for $10.6M and 498 claims (ranks #3 of 9, 75th percentile; typical) and J9271 (pembrolizumab) accounts for $3.9M and 531 claims (ranks #9 of 22, 62th percentile; typical). These entries suggest pockets of specialty infusion services (oncology/neuroimmunology) but not the primary revenue drivers compared with ED and infusion-for-dehydration codes.

Service breadth extends beyond emergency care into imaging, perinatal services, rehab, and transport: high-volume imaging codes include 70450 ($5.3M, 23.1K claims) and 74177 ($3.3M, 17.4K claims); perinatal monitoring 59025 appears at 17.7K claims ($2.6M); therapeutic exercise 97110 is 48.4K claims ($3.2M); and ambulance transports appear as A0431 ($3.2M) and A0434 ($1.3M). This mix indicates integrated inpatient/outpatient acute care with on-site imaging, maternal-fetal services, rehab, and significant EMS-related throughput.

Multiple individual codes are labeled as statistical outliers for statewide activity, highlighting unusually high utilization in specific services: examples include 99283 (99th percentile; extreme outlier), 99284 (98th percentile; extreme outlier), 97110 (99th percentile; extreme outlier), 96360 (98th percentile; extreme outlier), and 94640 (99th percentile; extreme outlier). Those labels point to utilization patterns far above typical state volume in ED, IV therapy, respiratory treatment, and physical therapy services, which may reflect the hospital’s role as a regional acute-care hub.

The facility has long operational tenure with an established NPI (NPI enumerated 2006-11-21 (~20 years ago)), and operational scale is apparent in raw claim volumes across multiple codes (e.g., 175.1K claims for 99284 and 175.3K claims for 80048). Combined longevity and large claim counts support the characterization of MIAMI VALLEY HOSPITAL as a long-standing, high-throughput acute-care provider within Ohio’s Medicaid network.

Medicaid: Complete Services Breakdown

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

575 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.	175,060	$130	$22.4M
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.	176,460	$120	$20.5M
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.	64,730	$290	$18.8M
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.	75,670	$140	$10.9M
J2350	Injection, ocrelizumab, 1 mg	500	$21,300	$10.6M
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.	23,110	$230	$5.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	43,150	$90	$4M
J9271	Injection, pembrolizumab, 1 mg	530	$7,430	$3.9M
0241U	N/A	32,990	$110	$3.7M
G0378	Hospital observation service, per hour	60,570	$60	$3.7M

Showing 1–10 of 575

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

Miami Valley Hospital — 15 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

575 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2350	Injection, ocrelizumab, 1 mg	3	10	310	$20,560	$10M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	23	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	9	20	360	$8,480	$5M
J2323	Injection, natalizumab, 1 mg	7	10	440	$4,300	$3.2M
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.	2	170	4,660	$300	$2.6M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	3	20	530	$2,040	$2.6M
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.	5	480	4,510	$90	$1.8M
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.	12	660	460	$90	$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.	19	580	510	$100	$1.3M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8	20	260	$1,470	$1.1M

Showing 1–10 of 575

Related Providers

Other providers that share a Tax Identification Number (TIN) with Miami Valley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Atrium Medical Center	OH	General Acute Care Hospital	$0	$27.5M

Nearby Providers

Other providers in the same ZIP code as Miami Valley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Miami Valley Emergency Specialists, LLC	OH	Emergency Medicine Physician	$0	$29.6M
Pediatrix Medical Group Of Ohio Corp	OH	Neonatal-Perinatal Medicine Physician	$0	$21.1M
Radiology Physicians Inc	OH	Diagnostic Radiology Physician	$0	$11.8M
Aliya Khan	OH	Rheumatology Physician	$1.6M	$0
Maria Thomas-john	OH	Rheumatology Physician	$1.2M	$0
Mark Marinella	OH	Medical Oncology Physician	$1.1M	$0
Mark Romer	OH	Hematology & Oncology Physician	$945.4K	$0
Burhan Yanes	OH	Hematology & Oncology Physician	$747.7K	$0
Shobha Wani	OH	Rheumatology Physician	$717.5K	$0
Douglas Einstein	OH	Radiation Oncology Physician	$689K	$0

Miami Valley Hospital — Billing Profile & Reimbursement Data

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Miami Valley Hospital — 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