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.

Memorial Hospital Inc. (NPI 1255471827)

Memorial Hospital Inc. is a rural health clinic/center provider located in Manchester, Kentucky. This profile covers 0 Medicare and 146 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	Memorial Hospital Inc.
Address	56 Marie Langdon Dr
City	Manchester
State	KY
ZIP	40962
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	February 6, 2007

Payer Source	Total Paid
Medicaid	$12.4M
Medicare	$0

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

146 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	153,380	$30	$5.2M
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…	84,540	$40	$3.7M
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…	5,330	$70	$394.3K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	6,650	$50	$358.9K
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…	5,100	$60	$311.1K
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…	4,450	$70	$293.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	16,230	$20	$243.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	10,770	$20	$172.4K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3,340	$40	$130.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	8,300	$10	$107.9K

Showing 1–10 of 146

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

Memorial Hospital 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

146 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	141	180	1,870	$280	$1.5M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	150	170	2,610	$250	$1M
H0038	Self‑help/peer services, per 15 minutes	156	320	3,070	$50	$678.3K
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.	165	180	2,960	$110	$672.4K
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…	204	210	1,340	$160	$568K
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…	207	1,270	760	$80	$447.2K
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…	31	3,340	1,020	$30	$296K
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	118	130	820	$160	$258.5K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	179	230	4,930	$20	$255.7K
0241U	N/A	50	50	1,460	$80	$254.2K

Showing 1–10 of 146

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital, Inc.	KY	Rural Acute Care Hospital	$0	$46.8M
Mathew Joseph	IL	Dermatology Physician	$279.5K	$0
Mitul Kanzaria	WA	Interventional Cardiology Physician	$210.4K	$0
Ashwini Anand	KY	Cardiovascular Disease Physician	$112.9K	$5.6K
Junaid Malik	FL	Pulmonary Disease Physician	$109.5K	$0
Ray Hays	KY	Hospitalist Physician	$42.1K	$0
Gregory Wilkens	KY	Surgery Physician	$20.5K	$0
Andrew Vaughn	TX	Otolaryngology Physician	$2.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clay Community Foundations, LLC	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.4M
Mountain Family Practice Clinic Of Manchester Inc	KY	Rural Health Clinic/Center	$0	$4.6M
Air Evac Ems Inc	KY	Air Ambulance	$566.7K	$3.6M
Family Health Care Associates	KY	Rural Health Clinic/Center	$0	$4.1M
Cumberland Valley District Health Department	KY	Home Health Agency	$0	$2.8M
Clay County Fiscal Court	KY	Land Ambulance	$399.1K	$1.6M
Keerthana Karumbaiah	KY	Cardiovascular Disease Physician	$432.3K	$0

Memorial Hospital Inc. — 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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