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

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

Mercy Health Physicians Youngstown, LLC (NPI 1154636066)

Mercy Health Physicians Youngstown, LLC is a family medicine physician provider located in Youngstown, Ohio. This profile covers 0 Medicare and 273 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	Mercy Health Physicians Youngstown, LLC
Address	1044 Belmont Ave
City	Youngstown
State	OH
ZIP	44504
Taxonomy	Family Medicine Physician
NPI Enumerated	August 16, 2010

Payer Source	Total Paid
Medicaid	$25.1M
Medicare	$0

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

273 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	184,860	$50	$8.9M
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…	228,540	$30	$7.3M
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	15,760	$70	$1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	34,300	$20	$617.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20,000	$30	$500.1K
99203	The provider sees a new 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 provider…	10,570	$50	$475.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	65,770	$10	$394.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	8,960	$30	$286.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	8,740	$30	$262.2K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3,490	$60	$216.2K

Showing 1–10 of 273

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Mercy Health Physicians Youngstown, LLC — 13 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

273 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	38	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	55	60	250	$730	$707.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,159	2,640	620	$90	$408.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	23	4,510	500	$60	$377.8K
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…	21	5,080	560	$40	$323.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	198	430	560	$60	$303.2K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	264	480	450	$70	$292.9K
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.	149	280	570	$250	$276.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	29	190	430	$70	$258.6K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	23	90	770	$100	$250.1K

Showing 1–10 of 273

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paul Gould	OH	Diagnostic Radiology Physician	$256.3K	$0
Joshua Apgar	OH	Diagnostic Radiology Physician	$188.6K	$7K
Kene Ugokwe	OH	Neurological Surgery Physician	$163.2K	$0
Keith Black	OH	Internal Medicine Physician	$150.9K	$0
Andrew Ryan	NC	Diagnostic Radiology Physician	$150.8K	$0
Lee Gemma	OH	Clinical Cardiac Electrophysiology Physician	$110.2K	$0
Venkata Kollipara	OH	Vascular Surgery Physician	$101.2K	$0
Chakri Yarlagadda	OH	Cardiovascular Disease Physician	$98.9K	$0
Pratheek Kakkasseril	OH	Vascular Surgery Physician	$78.1K	$0
Karim Hussein	OR	Cardiovascular Disease Physician	$65.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Youngstown LLC	OH	General Acute Care Hospital	$0	$63.7M
Mercy Health Physicians Youngstown Specialty Care LLC	OH	Surgery Physician	$0	$11.8M
Focuscare LLC	OH	Addiction (Substance Use Disorder) Counselor	$0	$8.5M
Mahoning Valley Emergency Specialists LLC	OH	Emergency Medicine Physician	$0	$7.7M
Dwight Heron	OH	Radiation Oncology Physician	$227.3K	$0
Albert Cook	OH	Vascular & Interventional Radiology Physician	$170.3K	$0
Nathaniel Doe	OH	Nephrology Physician	$145.8K	$1.2K
David Hoffman	OH	Cardiovascular Disease Physician	$138.3K	$0
Rodney Faulkiner	OH	Diagnostic Radiology Physician	$71K	$0
Mary Tondo	OH	Certified Registered Nurse Anesthetist	$69.7K	$0

Mercy Health Physicians Youngstown, LLC — Billing Profile & Reimbursement Data

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Mercy Health Physicians Youngstown, LLC — 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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