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

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

South Peninsula Hospital, Inc (NPI 1093968372)

Key Findings

Field	Value
Entity Type	Organization
Organization	South Peninsula Hospital, Inc
Address	4300 Bartlett St
City	Homer
State	AK
ZIP	99603
Taxonomy	Critical Access Hospital
NPI Enumerated	October 30, 2008

Payer Source	Total Paid
Medicaid	$30.1M
Medicare	$0

This provider has no Medicare billing on file and reports $30.1M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) reporting entity in the available claims data. The absence of Medicare activity means analyses of Medicare mix or national peer standing are not applicable for this hospital.

Revenue is concentrated in a small set of Medicaid service lines: the precomputed top-3 Medicaid codes account for 40.9% of the provider’s total Medicaid revenue, driven primarily by 99284 ($4.7M; 19.1%), 74177 ($2.7M; 11.0%), and G0378 ($2.7M; 10.8%). This concentration indicates a high reliance on emergency department, advanced imaging, and observation-hour billing for Medicaid revenue.

The code mix (99284, 99283, 99285 and G0378) points to an emergency/acute-care operational profile with sustained observation-unit use. High-dollar imaging codes such as 74177 (CT abdomen/pelvis with contrast, $2.7M) and 70450 (CT head, $834K) further indicate on-site CT capacity supporting ED and observation throughput.

Competitive standing on key Medicaid codes is largely mid-pack in-state: 99284 ranks #17 of 42 (61th percentile; typical, unremarkable volume for this code), 74177 ranks #15 of 28 (48th percentile; typical, unremarkable volume for this code), and G0378 ranks #8 of 15 (50th percentile; typical, unremarkable volume for this code). These positions suggest the hospital is a modest regional participant for its highest-revenue acute services rather than a dominant statewide provider for those services.

Several outpatient and ancillary service lines show relatively strong statewide positioning, indicating breadth beyond emergency care. Physical therapy codes 97140 (10.9K claims, $915.3K; ranks #3 of 68, 97th percentile; notably above typical state volume for this code) and 97110 (11.2K claims, $786.5K; ranks #10 of 116, 92th percentile; notably above typical state volume for this code) are notable strengths, while the lab respiratory panel 87633 (2.2K claims, $558.2K) is ranked #1 of 11 (100th percentile; notably above typical state volume for this code).

High-volume basic lab testing and monitoring suggest substantial inpatient and outpatient lab throughput: 85025 (18.8K claims, $846.3K), 80053 (16.3K claims, $797.8K), and TSH testing 84443 (6.2K claims, $246.5K) are among the top Medicaid-coded services. These large claim counts paired with mid-range average payments indicate core laboratory services contribute meaningfully to Medicaid revenue and clinical operations.

The presence of multiple ED E/M levels across the top codes (99282–99285) combined with infusion/IV administration codes (96365, 96361, 96375, 96374) signals the facility manages a mix of acute medical, observation, and infusion therapies on-site. Infusion-related codes appear as typical volumes in-state (e.g., 96365 ranks #9 of 24, 65th percentile; typical, unremarkable volume for this code), supporting a service mix that includes emergency stabilization plus therapeutic infusions.

Organizational tenure is long enough to evaluate trends: the NPI was enumerated 2008-10-30 (~18 years ago), indicating sustained presence in the market. Given the Critical Access Hospital taxonomy and the Medicaid-dominant revenue profile, the provider functions as a stable local acute-care and ancillary services hub with particular strengths in physical therapy and lab respiratory testing, even as its ED/observation revenue sits at typical in-state levels.

Medicaid: Complete Services Breakdown

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

172 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.	7,640	$620	$4.7M
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.	2,170	$1,260	$2.7M
G0378	Hospital observation service, per hour	1,530	$1,760	$2.7M
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.	6,320	$380	$2.4M
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.	2,240	$990	$2.2M
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	10,900	$80	$915.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	18,810	$50	$846.3K
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.	1,560	$540	$834K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	16,280	$50	$797.8K
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…	11,240	$70	$786.5K

Showing 1–10 of 172

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alaska Distribution

South Peninsula Hospital, Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alaska

Full comparison — all codes billed, vs. Alaska median

172 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	17	40	5,090	$240	$3.5M
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.	18	40	2,210	$300	$3.2M
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.	21	50	4,500	$170	$2.5M
G0378	Hospital observation service, per hour	8	20	1,530	$750	$1.9M
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.	15	30	2,190	$390	$1.3M
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	34	100	360	$340	$1.2M
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.	19	30	3,420	$220	$1.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	10	20	4,510	$130	$1.1M
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…	36	490	680	$260	$1M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	20	20	2,210	$160	$976.1K

Showing 1–10 of 172

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Peninsula Hospital, Inc.	AK	Critical Access Hospital	$0	$2.7M
Alan Skolnick	AK	Cardiovascular Disease Physician	$473.3K	$0
Linda Ireland	AK	Cardiovascular Disease Physician	$389.7K	$0
Adam Mason	AK	Cardiovascular Disease Physician	$374.7K	$0
Lisa Gray	AK	Cardiovascular Disease Physician	$338.9K	$0
Mario Binder	AK	Cardiovascular Disease Physician	$316.8K	$0
Yiming Wu	AK	Clinical Cardiac Electrophysiology Physician	$305K	$0
Daniel Davignon	AK	Diagnostic Radiology Physician	$248.8K	$21.1K
Graham Glass	CA	Neurology Physician	$259.2K	$0
Jonathan Mcdonagh	AK	Vascular Surgery Physician	$247.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Peninsula Behavioral Health Services Inc	AK	Community/Behavioral Health Agency	$0	$21.6M
Seldovia Village Tribe	AK	Federally Qualified Health Center (FQHC)	$0	$10.1M
South Peninsula Behavioral Health Svcs Inc	AK	Respite Care	$0	$4.4M
Prodigy Medical, LLC	AK	Oxygen Equipment & Supplies (DME)	$0	$1.5M
James Bourne Dds PC	AK	Dentist	$0	$1.4M
Michael Connors	AK	Optometrist	$0	$1.4M
Homer Eyecare LLC	AK	Optometrist	$0	$1.2M
Homer Senior Citizens, Inc.	AK	Assisted Living Facility	$0	$1.2M
Zank Center, LLC	AK	Speech-Language Pathologist	$0	$1M
Akideas Limited Liability Corporation	AK	Case Management Agency	$0	$950.6K

South Peninsula Hospital, Inc — 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