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.

Fairview Hospital (NPI 1215989611)

Field	Value
Entity Type	Organization
Organization	Fairview Hospital
Address	18101 Lorain Ave
City	Cleveland
State	OH
ZIP	44111
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$62.3M
Medicare	$0

Key Findings

FAIRVIEW HOSPITAL is effectively a single‑payer Medicaid provider in the available records: Medicare revenue is listed as none while total Medicaid revenue is $62.3M. This concentration means analyses of this facility’s commercial and Medicare exposure cannot be performed from the supplied billing files and any payer-strategy conclusions should be Medicaid‑centric.

Revenue is heavily concentrated in a small set of emergency and infusion codes: the precomputed top 3 Medicaid codes by revenue account for 44.2% of this provider's total Medicaid revenue, led by 99285 ($9M, 17.1%), 99283 ($7.3M, 13.9%), and 96361 ($6.9M, 13.2%). That level of concentration highlights how a few services drive nearly half of reported Medicaid receipts and should be the focus for utilization and revenue-variance monitoring.

The code mix indicates a strong emergency‑department and acute outpatient/infusion orientation: high-volume E/M ED codes (99285, 99283, 99284) plus observation (G0378) and outpatient clinic visits (G0463) together suggest the hospital operates with substantial ED throughput and supports post‑ED observation/infusion care. The prominence of infusion/IV hydration codes (96361, 96365, 96366, 96360) further implies recurring use of IV therapies and prolonged ED/observation stays rather than primarily elective inpatient procedures.

On competitive standing within Ohio, FAIRVIEW shows above-typical statewide volume for several high-impact codes: 99285 ranks #22 of 581 providers (96th percentile; notably above typical state volume for this code), 96361 ranks #12 of 165 (93th percentile; typical, unremarkable volume for this code), and G0378 ranks #9 of 155 (95th percentile; notably above typical state volume for this code). Simultaneously, 0241U is an extreme outlier with rank #2 of 88 (99th percentile), indicating unusually high use of that specific code compared with in‑state peers.

High-cost drug administration appears present but not dominant: J9271 (pembrolizumab) generated $2.1M (4.0%) on 263 claims and ranks #12 of 22 providers in-state (48th percentile), indicating the hospital administers checkpoint inhibitor therapy at modest relative volume. J2350 (ocrelizumab) shows $455.2K (0.9%) on 24 claims and ranks #9 of 9 providers (0th percentile), reflecting very limited statewide participation for that agent.

Imaging and laboratory volumes support the ED/acute profile rather than elective specialty surgery: 70450 (CT head) produced $1.4M (2.7%), 74177 (CT abdomen/pelvis with contrast) $1M (2.0%), and the comprehensive metabolic panel 80053 accounted for $517.1K (1.0%) on 86.2K claims (rank #19 of 274, 93th percentile). These diagnostics figures are consistent with sustained diagnostic throughput tied to emergency and observation services rather than primarily outpatient clinic imaging.

Operationally and for contracting, payers should note the combined signal of high ED E/M revenue, substantial observation billing, and concentrated infusion activity: those service lines (and the fact that the top 3 codes account for 44.2% of Medicaid revenue) present the clearest levers for utilization management, rate negotiation, and targeted medical‑policy review. The presence of an extreme outlier code (0241U, rank #2 of 88; 99th percentile) suggests a targeted clinical review or documentation check for that specific service is warranted to understand clinical necessity and coding context.

FAIRVIEW HOSPITAL’s NPI was enumerated on 2006-05-16 (~20 years ago), indicating long-standing presence in the Cleveland market; combined with its elevated state percentiles on several ED and observation codes, the facility appears to be an established acute-care access point with significant Medicaid reliance. Analysts benchmarking network adequacy or negotiating Medicaid arrangements should treat this provider as a longstanding, high-volume ED/observation facility in-state.

Medicaid: Complete Services Breakdown

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

520 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	71,130	$130	$9M
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.	64,880	$110	$7.3M
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.	25,070	$280	$6.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	60,600	$80	$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.	39,570	$120	$4.6M
0241U	N/A	22,950	$130	$3.1M
G0378	Hospital observation service, per hour	29,430	$80	$2.2M
J9271	Injection, pembrolizumab, 1 mg	260	$7,980	$2.1M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	5,990	$240	$1.4M
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.	10,110	$110	$1.1M

Showing 1–10 of 520

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

Fairview Hospital — 2 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

520 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2350	Injection, ocrelizumab, 1 mg	9	10	310	$20,560	$10M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	20	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	12	20	360	$8,480	$5M
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.	12	170	4,660	$300	$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.	43	480	4,510	$90	$1.8M
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.	78	660	460	$90	$1.5M
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.	22	580	510	$100	$1.3M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	20	140	1,130	$90	$1.1M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	46	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	30	60	250	$730	$707.7K

Showing 1–10 of 520

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clinic Medical Services Company	OH	Diagnostic Radiology Physician	$410.1K	$0
Ashley Major	OH	Family Nurse Practitioner	$3.6K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Circle Health Services	OH	Federally Qualified Health Center (FQHC)	$0	$7.9M
Eagle Medical Services , LLC	OH	Home Health Agency	$0	$7.3M
Walid Thabet & Partners LLC	OH	Dentist	$0	$6.7M
Hassan Alzoubi	OH	Internal Medicine Physician	$302.3K	$1.2M
Sebouh Setrakian	OH	Anatomic Pathology & Clinical Pathology Physician	$204.9K	$0
Christopher Reese	OH	Urology Physician	$190K	$0
James Kontak	OH	Urology Physician	$162K	$0
Stephen Smik	OH	Podiatrist	$89.3K	$0
Mark Melaragno	OH	Anatomic Pathology & Clinical Pathology Physician	$81.5K	$0
David Rosen	OH	Colon & Rectal Surgery Physician	$76.2K	$0

Fairview Hospital — Billing Profile & Reimbursement Data

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Fairview Hospital — 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