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

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

St Elizabeth Medical Center, Inc (NPI 1114974813)

Field	Value
Entity Type	Organization
Organization	St Elizabeth Medical Center, Inc
Address	238 Barnes Rd
City	Williamstown
State	KY
ZIP	41097
Taxonomy	Critical Access Hospital
NPI Enumerated	May 28, 2006

Payer Source	Total Paid
Medicaid	$35.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

192 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.	27,760	$350	$9.8M
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.	10,330	$570	$5.9M
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.	5,580	$650	$3.6M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	12,230	$130	$1.6M
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.	7,410	$200	$1.5M
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.	4,260	$330	$1.4M
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.	6,980	$130	$921.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	49,470	$20	$742K
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…	8,220	$70	$550.6K
J3490	Unclassified drugs	19,440	$30	$544.3K

Showing 1–10 of 192

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

St Elizabeth Medical Center, Inc — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

192 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.	116	280	7,150	$150	$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.	114	240	4,710	$150	$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.	48	280	5,700	$120	$2M
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.	62	180	1,870	$280	$1.5M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	67	80	7,740	$30	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	114	170	2,610	$250	$1M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	80	80	990	$60	$912.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	46	50	2,340	$200	$829.7K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	42	110	8,390	$50	$749.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	217	340	2,700	$40	$673.3K

Showing 1–10 of 192

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Elizabeth Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$41.7K	$188.3M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$65.5M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$46M
St Elizabeth Medical Center, Inc	IN	General Acute Care Hospital	$0	$4.6M
St Elizabeth Medical Center, Inc	KY	Physician Assistant	$0	$3.8M
St Elizabeth Medical Center, Inc	KY	Community Based Hospice Care Agency	$0	$3M
Peter Fried	OH	Radiation Oncology Physician	$904.7K	$0
Shoaib Ahmad	OK	Pulmonary Disease Physician	$276.1K	$0
William Willmott	KY	Sleep Medicine (Internal Medicine) Physician	$264.9K	$0
Mohamad Sinno	KY	Clinical Cardiac Electrophysiology Physician	$246.6K	$0

Nearby Providers

Other providers in the same ZIP code as St Elizabeth Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Air Evac Ems Inc.	KY	Air Ambulance	$361.6K	$688.4K

St Elizabeth Medical Center, Inc — Billing Profile & Reimbursement Data

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St Elizabeth Medical Center, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References