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

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

Meriter Hospital, Inc. (NPI 1114920048)

Field	Value
Entity Type	Organization
Organization	Meriter Hospital, Inc.
Address	202 S Park St
City	Madison
State	WI
ZIP	53715
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicaid	$25.5M
Medicare	$0

Key Findings

MERITER HOSPITAL, INC. reports no Medicare billing on file and $25.5M in lifetime Medicaid revenue, making its reported activity effectively single‑payer Medicaid in the available claims data; analysts should treat Medicaid as the primary payer when profiling this provider.

Revenue is concentrated in a small set of services: the precomputed top three Medicaid codes (96361, 99283, 99284) account for 39.8% of the provider's total Medicaid revenue, indicating a high dependence on a few high-volume ED and IV infusion service lines.

The code mix and top revenue drivers point to a hospital operating with substantial emergency department throughput and infusion services. Key ED evaluation and management codes 99283 ($2.5M, 13.6% of Medicaid revenue) and 99284 ($2.3M, 12.5% of Medicaid revenue) are among the largest revenue contributors, and multiple infusion/IV administration codes (96361 $2.5M, 13.8%; 96365 $773.4K; 96360 $516K; 96366 $399.3K) appear throughout the top codes, consistent with an ED and infusion-focused operational profile.

On competitive standing within Wisconsin the provider posts high statewide ranks for several major ED and infusion codes: 99283 ranks #14 of 362 (96th percentile; notably above typical state volume), 99284 ranks #15 of 432 (97th percentile; typical, unremarkable volume), and 96361 ranks #7 of 135 (96th percentile; typical, unremarkable volume). These placements indicate MERITER is a major participant in ED and infusion activity statewide rather than a low‑volume outlier.

MERITER shows programmatic specialization in maternal/fetal imaging and behavioral health: code 76815 (limited fetal ultrasound) is an extreme outlier, ranking #1 of 54 providers in‑state (100th percentile; extreme outlier, far above typical state volume) with $306.8K in revenue, and group psychotherapy 90853 ranks #3 of 110 (98th percentile; notably above typical state volume) with $531.3K in revenue, suggesting sizable obstetrics imaging and group behavioral‑health throughput.

The provider administers notable volumes of high‑cost biologic and specialty infusion products alongside routine infusions: J2350 (ocrelizumab) generated $638.2K and ranks #2 of 4 (67th percentile; typical, unremarkable volume), Q5104 (infliximab biosimilar) generated $501.2K and ranks #1 of 2 (100th percentile; typical, unremarkable volume), and J1569 (immune globulin) generated $430.3K and ranks #3 of 5 (50th percentile; typical, unremarkable volume). This mix indicates an operational capacity to deliver specialty biologics but also reflects small statewide provider counts for some specialty drug codes, so peer comparisons can be sensitive to sample size.

Laboratory and imaging throughput supports the hospital profile: comprehensive metabolic panels (80053) appear with $540.9K revenue and rank #23 of 261 (92nd percentile; typical, unremarkable volume), and head CTs (70450) generated $351.6K ranking #30 of 221 (87th percentile; typical, unremarkable volume), consistent with a full‑service acute care hospital supporting ED and inpatient workflows.

The NPI was enumerated on 2005-05-24 (~21 years ago), indicating an established presence in the market; given the longevity and the concentration of high‑percentile ED, infusion, obstetric imaging, and behavioral‑health codes, the provider appears to operate mature service lines that drive the majority of its Medicaid revenue.

Medicaid: Complete Services Breakdown

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

335 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	22,840	$110	$2.5M
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.	40,250	$60	$2.5M
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.	40,990	$60	$2.3M
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.	21,370	$50	$961.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,720	$310	$839.9K
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.	15,780	$50	$773.4K
J2350	Injection, ocrelizumab, 1 mg	170	$3,690	$638.2K
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.	38,640	$10	$540.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	12,650	$40	$531.3K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	6,880	$80	$516K

Showing 1–10 of 335

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Meriter Hospital, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

335 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	46	50	8,810	$110	$2.2M
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.	7	140	3,200	$160	$1.1M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	3	10	2,330	$400	$916.4K
J2350	Injection, ocrelizumab, 1 mg	2	10	140	$3,710	$705.3K
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.	14	360	1,550	$70	$614.4K
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.	15	430	760	$60	$484.6K
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.	33	190	1,790	$90	$390.9K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	4	40	150	$530	$381.9K
96040	Medical genetics and genetic counseling services, each 30 minutes face‑to‑face with patient/family	2	10	2,780	$100	$381K
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.	6	140	2,200	$90	$358.4K

Showing 1–10 of 335

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Claudiu Gherlan	WI	Internal Medicine Physician	$106.4K	$0
Michael Pomroy	WI	Dermatology Physician	$103.3K	$0
N Casper	WI	Internal Medicine Physician	$99.6K	$0
David Lewis	WI	Interventional Cardiology Physician	$68.4K	$0
Steven Garlow	WI	Psychiatry Physician	$65.7K	$0
Henry Riter	MN	Cardiovascular Disease Physician	$58.2K	$0
Jeffrey Larson	WI	Plastic and Reconstructive Surgery Physician	$54.3K	$0
Peter Redford	VT	Internal Medicine Physician	$53.5K	$0
Thomas Wallhaus	WI	Cardiovascular Disease Physician	$49.8K	$0
Douglas Kutz	WI	Internal Medicine Physician	$49.7K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dean Health Systems, Inc	WI	Allergy & Immunology Physician	$0	$26.3M
Ssm Health Care Of Wisconsin, Inc.	WI	General Acute Care Hospital	$0	$14.7M
Ssm Health Care Of Wisconsin, Inc	WI	Clinical Medical Laboratory	$0	$6.4M
Madison Surgery Center, Inc.	WI	Ambulatory Surgical Clinic/Center	$3.6M	$549.2K
Ryan Bros Ambulance LLC	WI	Land Ambulance	$1.5M	$2.3M
Madison Emergency Physicians, Sc	WI	Emergency Medicine Physician	$0	$3.2M
Dean Health Systems, Inc.	WI	Ambulatory Surgical Clinic/Center	$2M	$856.3K
Emergency Medicine Associates Of Madison, Sc	WI	Emergency Medicine Physician	$0	$2.1M
Amol Kulkarni	WI	Ophthalmology Physician	$2.1M	$0
Meriter Health Enterprises Inc.	WI	Clinical Medical Laboratory	$680.6K	$1M

Meriter Hospital, Inc. — Billing Profile & Reimbursement Data

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Meriter 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