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

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

Froedtert Memorial Lutheran Hospital, Inc. (NPI 1255334173)

Field	Value
Entity Type	Organization
Organization	Froedtert Memorial Lutheran Hospital, Inc.
Address	9200 W Wisconsin Ave
City	Milwaukee
State	WI
ZIP	53226
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 24, 2005

Payer Source	Total Paid
Medicaid	$157.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer on the available federal data: there is no Medicare billing on file while reported Medicaid revenue totals $157.8M, indicating Medicaid is the dominant public payer in the dataset for FROEDTERT MEMORIAL LUTHERAN HOSPITAL, INC. Analysts should treat the profile as Medicaid‑centric when assessing payer mix and service footprint.

Revenue concentration is high: the precomputed top three Medicaid codes by revenue account for 37.1% of total Medicaid revenue, led by 99211 ($17.3M, 19.5%), followed by 99212 ($8.2M, 9.2%) and 96361 ($7.4M, 8.4%). This concentration signals that a small set of high‑volume outpatient E/M and IV‑infusion codes drive a large share of the hospital’s Medicaid receipts.

The code mix strongly indicates a high-volume outpatient/ambulatory practice component: 99211 (244.4K claims, $71 avg, ranks #1 of 354, 100th percentile, extreme outlier) and 99212 (122.5K claims, $67 avg, ranks #2 of 687, 100th percentile, extreme outlier) are among the top revenue sources, suggesting extensive low-acuity established patient visits and clinic workflows billed under the hospital’s NPI. These patterns are consistent with a hospital that operates large outpatient clinic networks or high-throughput ambulatory services within its Medicaid population.

Emergency department and acute evaluation services are also a meaningful revenue stream: 99284 (95.4K claims, $60 avg, $5.7M, ranks #6 of 432, 99th percentile, extreme outlier), 99283 (75.5K claims, $66 avg, $5.0M, ranks #6 of 362, 99th percentile, extreme outlier) and 99282 (22.6K claims, $74 avg, $1.7M, ranks #5 of 191, 98th percentile, notably above typical) together reflect large ED volume across low-to-moderate complexity encounters. This mix underscores significant emergency care throughput on Medicaid beyond the outpatient clinic activity.

Infusion, oncology, and blood‑product services form a distinct clinical cluster: high volumes for infusion administration codes 96365 (39.5K claims, $83 avg, $3.3M, ranks #1 of 135, 100th percentile, extreme outlier), 96366 (19K claims, $107 avg, $2.0M, ranks #2 of 85, 99th percentile, extreme outlier) and chemotherapy administration 96413 (28.2K claims, $65 avg, $1.8M, ranks #1 of 56, 100th percentile, extreme outlier) alongside drug revenues such as J9271 and J1745 and blood product P9016. These entries indicate the hospital is a major statewide provider of infusion/chemotherapy and transfusion services for Medicaid patients.

The provider also shows extensive ancillary service volume across laboratory, imaging, ophthalmology and radiation: 80048 (168.4K claims, $29 avg, $4.9M, ranks #1 of 219, 100th percentile, extreme outlier), 80053 (114.1K claims, $37 avg, $4.2M, ranks #4 of 261, 99th percentile), 85025 (209.2K claims, $6 avg, $1.3M, ranks #3 of 299, 99th percentile) and imaging codes like 70450 and 74177 appear high in-state. The presence of 92012 (59.8K claims, $48 avg, $2.9M, ranks #1 of 50, 100th percentile, extreme outlier) and 77386 (12.5K claims, $169 avg, $2.1M, ranks #1 of 3, 100th percentile) reflects a broad clinical footprint that includes ophthalmology and complex radiation delivery services.

Competitive standing within Wisconsin is pronounced: multiple high-revenue codes are state leaders (many at 100th percentile and labeled extreme outlier), including 99211, 80048, 96365, 92012 and others, demonstrating dominance across outpatient, infusion and ancillary lines. A few high-cost drug codes (for example J9271 ranks #2 of 6 at the 80th percentile) are more typical in-state, indicating pockets where the hospital’s market share is meaningful but not singularly dominant.

The provider has an established administrative presence, with NPI enumeration dated 2005-05-24 (~21 years ago), supporting interpretation of these high and concentrated Medicaid volumes as sustained operational patterns rather than short-term anomalies. Taken together, the data depict a long‑standing general acute care hospital with a Medicaid-focused revenue base and statewide leadership across multiple high-volume outpatient, infusion, emergency, laboratory and imaging services.

Medicaid: Complete Services Breakdown

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

986 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	244,360	$70	$17.3M
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,…	122,460	$70	$8.2M
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.	54,370	$140	$7.4M
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.	95,420	$60	$5.7M
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.	75,520	$70	$5M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	168,390	$30	$4.9M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	114,060	$40	$4.2M
J9271	Injection, pembrolizumab, 1 mg	2,280	$1,510	$3.4M
P9016	Red blood cells, leukocytes reduced, each unit	4,930	$700	$3.4M
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.	39,530	$80	$3.3M

Showing 1–10 of 986

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Froedtert Memorial Lutheran Hospital, Inc. — 23 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

986 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	2	10	200	$1,270	$1.4M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	1	10	8,330	$140	$1.4M
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.	2	140	3,200	$160	$1.1M
J1569	Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg	1	10	2,330	$400	$916.4K
P9016	Red blood cells, leukocytes reduced, each unit	2	10	750	$590	$906.4K
J2505	Injection, pegfilgrastim, 6 mg	1	10	1,220	$660	$807.2K
J2350	Injection, ocrelizumab, 1 mg	4	10	140	$3,710	$705.3K
J0588	Injection, incobotulinumtoxin a, 1 unit	3	10	1,370	$280	$624.7K
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.	6	360	1,550	$70	$614.4K
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.	6	430	760	$60	$484.6K

Showing 1–10 of 986

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wisconsin Diagnostic Laboratories LLC	WI	Clinical Medical Laboratory	$2.3M	$22.7M
Community Memorial Hospital Of Menomonee Falls Inc	WI	General Acute Care Hospital	$0	$10M
St. Josephs Community Hospital Of West Bend Inc.	WI	General Acute Care Hospital	$0	$5.8M
Holy Family Memorial Inc	WI	General Acute Care Hospital	$0	$5M
Kevan Lewis	WI	MOHS-Micrographic Surgery Physician	$1.2M	$0
Riley Smyth	WI	Diagnostic Radiology Physician	$805.1K	$320
Aaron Gould	IL	Diagnostic Radiology Physician	$126.2K	$209.3K
Trudi Parker	MN	Diagnostic Radiology Physician	$317.2K	$0
John Lawton	WI	Nephrology Physician	$203.3K	$0
Brent King	MN	Diagnostic Radiology Physician	$197.8K	$0

Nearby Providers

Other providers in the same ZIP code as Froedtert Memorial Lutheran Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Of Wisconsin, Inc.	WI	Children's Hospital	$0	$262.3M
The Medical College Of Wisconsin, Inc.	WI	Internal Medicine Physician	$17.8K	$74.8M
Emergency Medicine Specialists, S.c.	WI	Emergency Medicine Physician	$0	$35.3M
Childrens Hospital Of Wisconsin, Inc.	WI	Pediatrics Physician	$0	$19M
Children's Hospital And Health System, Inc.	WI	Urgent Care Clinic/Center	$0	$17.7M
Option Care Home Care Inc	WI	Pharmacy	$0	$12.5M
Curative Care Network, Inc.	WI	Rehabilitation Clinic/Center	$0	$12.2M
Children's Specialty Group, Inc.	WI	Pediatrics Physician	$0	$10.4M
Brian Blocher	WI	Oral & Maxillofacial Surgery (D.M.D.)	$0	$5.5M
Nicholas Tosi	WI	Retina Specialist (Ophthalmology) Physician	$4.9M	$0

Froedtert Memorial Lutheran Hospital, Inc. — Billing Profile & Reimbursement Data

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Froedtert Memorial Lutheran Hospital, 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