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

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

Methodist Hospital (NPI 1134297393)

Methodist Hospital is a general acute care hospital provider located in Philadelphia, Pennsylvania. This profile covers 0 Medicare and 175 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	Methodist Hospital
Address	2301 South Broad
City	Philadelphia
State	PA
ZIP	19145
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 4, 2006

Payer Source	Total Paid
Medicaid	$10.7M
Medicare	$0

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

175 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.	20,350	$210	$4.2M
G0378	Hospital observation service, per hour	2,060	$840	$1.7M
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.	7,010	$220	$1.5M
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	3,430	$160	$535.5K
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.	2,220	$210	$469.3K
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.	2,100	$150	$319.4K
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…	980	$220	$210.1K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	3,400	$40	$139.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	230	$500	$114.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	270	$370	$97.3K

Showing 1–10 of 175

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Methodist Hospital — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

175 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	36	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	738	1,690	760	$170	$1.2M
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.	134	210	730	$40	$689.7K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	44	70	620	$60	$464.8K
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.	66	1,600	270	$120	$409.7K
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.	126	1,060	150	$130	$405.4K
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.	169	1,230	250	$130	$284K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	689	710	320	$40	$241.4K
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…	30	90	440	$120	$162.5K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	23	70	320	$90	$139.3K

Showing 1–10 of 175

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Jefferson University Hospitals Inc	PA	General Acute Care Hospital	$0	$40.3M
Anthony Boniello	NJ	Orthopaedic Surgery Physician	$274.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norah's Care Agency, LLC.	PA	Home Health Agency	$0	$15.5M
Crisis Management Services	PA	Substance Abuse Rehabilitation Facility	$0	$13.7M
City Of Philadelphia	PA	Federally Qualified Health Center (FQHC)	$0	$13.5M
Children's Hospital Of Philadelphia	PA	Pediatrics Physician	$0	$5.5M
American Access Care Of Sp Asc LLC	PA	Ambulatory Surgical Clinic/Center	$2.5M	$267.2K
Stadium Campus Ambulatory Surgical Center, LLC	PA	Ambulatory Surgical Clinic/Center	$793.2K	$1.4M
Briana Massetti	PA	Acute Care Nurse Practitioner	$565.7K	$55K
Eric Newman	PA	Nephrology Physician	$455.4K	$4.5K
Wayne Dunn	PA	Ophthalmology Physician	$425.6K	$0
Concetta Milano	PA	Cardiovascular Disease Physician	$419.9K	$0

Methodist Hospital — Billing Profile & Reimbursement Data

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Methodist Hospital — 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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