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 1154365062)

Field	Value
Entity Type	Organization
Organization	St Elizabeth Medical Center, Inc
Address	4900 Houston Rd
City	Florence
State	KY
ZIP	41042
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 15, 2006

Payer Source	Total Paid
Medicaid	$65.5M
Medicare	$0

Key Findings

ST ELIZABETH MEDICAL CENTER, INC reports $65.5M in lifetime Medicaid revenue and has no Medicare billing on file, making its public billing footprint effectively single‑payer under Medicaid. The provider’s NPI was enumerated on 2006-06-15 (~20 years ago), indicating about two decades of active billing history in the data set.

Revenue concentration is heavily weighted to emergency department evaluation and management codes: the precomputed top‑3 Medicaid codes account for 48.6% of the provider’s total Medicaid revenue. Those top codes are 99283 ($12.3M, 24.0%), 99284 ($8M, 15.6%), and 99285 ($4.6M, 8.9%), which together signal that ED visits are the primary revenue driver for this hospital.

The code mix points to a high-volume, ED-centric acute care model with substantial observation and ancillary services. In addition to ED E/M codes, G0378 (hospital observation service, $1.7M, 3.3%) and high counts of basic ED treatments such as 96374 (IV medication administration, $2.1M, 4.2%) and 96361 (IV fluids add‑on, $791.9K, 1.5%) underscore routine inpatient/observation throughput linked to emergency presentations.

While ED codes dominate revenue, the facility also generates material Medicaid revenue from non‑ED procedures that align with a full-service acute hospital. Examples include 41899 (dental/teeth procedures, $3.8M, 7.5%), 47562 (laparoscopic cholecystectomy, $1.1M, 2.1%), and endoscopy codes such as 43239 ($950.4K, 1.9%) and 45385 ($493.9K, 1.0%), indicating operative and procedural capacity beyond emergency care.

Competitive standing across in‑state peers is mixed by service line: for several ancillary services ST ELIZABETH ranks near the top of the state. Notable positions include 95811 (rank #2 of 52, 98th percentile) and 95810 (rank #4 of 73, 96th percentile) for polysomnography, 36415 (rank #28 of 731, 96th percentile) for phlebotomy volume, and J3490 (rank #5 of 104, 96th percentile) for unclassified drug claims — each labeled in the data as notably above typical state volume.

For ED acuity mix the hospital shows particularly strong volume at lower to moderate ED complexity relative to peers. 99283 is ranked #16 of 284 (95th percentile) and 99284 is #57 of 282 (80th percentile), while higher‑acuity 99285 is a more modest statewide participant at #60 of 239 (75th percentile). The pattern suggests high overall ED throughput with relatively greater volume in lower and moderate complexity visits.

Several codes are flagged as statistical outliers in the dataset and suggest service‑line specializations: 99282 (rank #8 of 158, 96th percentile) and 95811 (rank #2 of 52, 98th percentile) are described as notably above typical state volume, and 36415 and J3490 are both at the 96th percentile described as notably above typical. Conversely, some high‑revenue ED codes are described in the source as "typical, unremarkable volume" despite high percentiles, which is an important nuance when benchmarking against peers.

Operationally, the mix of high‑volume ED E/M codes plus material revenue from observation (G0378), procedural surgery (47562), pain interventions (64493, 64635), and sleep studies (95810/95811) is consistent with a general acute care hospital that functions as a regional emergency and specialty‑procedure hub. Given the lack of Medicare billing on file, any payer‑mix or reimbursement strategy analysis should treat the available public record as predominantly Medicaid‑driven.

Medicaid: Complete Services Breakdown

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

336 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.	56,260	$220	$12.3M
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.	24,460	$330	$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.	11,900	$390	$4.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,600	$2,400	$3.8M
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.	20,710	$140	$2.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	24,540	$90	$2.1M
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.	8,710	$200	$1.7M
G0378	Hospital observation service, per hour	9,020	$190	$1.7M
64493	The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…	1,800	$900	$1.6M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	2,580	$590	$1.5M

Showing 1–10 of 336

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 — 6 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

336 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.	57	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.	60	240	4,710	$150	$2.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	10	140	$3,650	$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.	16	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	15	40	740	$1,170	$1.7M
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.	35	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	18	90	2,770	$190	$1.3M
C1776	Joint device (implantable)	15	20	130	$2,890	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	58	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	30	40	550	$910	$1.1M

Showing 1–10 of 336

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	$46M
St Elizabeth Medical Center, Inc	KY	Critical Access Hospital	$0	$35.4M
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
Personal Touch Home Care Of Ky, Inc.	KY	Home Health Agency	$0	$127.2M
Northern Kentucky Consumer Directed Options Program	KY	Supports Brokerage Agency	$0	$52.8M
Healthy Adult Day Healthcare, LLC	KY	Adult Day Care Clinic/Center	$0	$37.7M
Dungarvin Kentucky, LLC - Florence	KY	Developmentally Disabled Services Day Training Agency	$0	$35.3M
Northern Kentucky Consumer Directed Option Program	KY	Supports Brokerage Agency	$0	$27.5M
Personal Touch Home Care Of Ky, Inc.	KY	Home Health Agency	$0	$13.2M
Tri-generations, LLC	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$11.2M
Bawac, Inc.	KY	Developmentally Disabled Services Day Training Agency	$0	$5.5M
Advanced Technology Of Kentucky Inc.	KY	Oxygen Equipment & Supplies (DME)	$0	$5.1M
Northern Kentucky Center For Pain Relief, LLC	KY	Pain Medicine (Anesthesiology) Physician	$0	$4.8M

St Elizabeth Medical Center, 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