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.

Owensboro Health Inc (NPI 1285613612)

Key Findings

Field	Value
Entity Type	Organization
Organization	Owensboro Health Inc
Address	1201 Pleasant Valley Rd
City	Owensboro
State	KY
ZIP	42303
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 13, 2006

Payer Source	Total Paid
Medicaid	$148.8M
Medicare	$0

This provider is effectively single‑payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $148.8M, so Medicaid represents the entirety of reported public-payer activity for this profile. Analysts should treat Medicaid flows as the primary source for any volume- or revenue-based benchmarking of this entity.

OWENSBORO HEALTH INC has been enumerated for a long-tenured operating period (NPI enumerated 2006-01-13 (~20 years ago)), indicating stable presence in the market and a multi-year opportunity to accumulate the service mix reflected in the Medicaid data. This tenure supports interpreting persistent operational patterns rather than a short-term anomaly.

Revenue is highly concentrated in emergency department evaluation-and-management services: the precomputed top three Medicaid codes account for 43.5% of Medicaid revenue, and the specific top codes are 99284, 99285, and 99283. That concentration indicates the ED is the primary revenue driver for Medicaid payments and should be the focus for business-line analysis, capacity planning, and payer-negotiation attention.

ED and acute-care intensity is reinforced by supporting high-acuity codes: 99291 (4.7K claims, $1.9M revenue) and hospital observation G0378 (24.2K claims, $2.4M revenue) both rank highly in-state (99291 at the 89th percentile and G0378 at the 94th percentile). These volumes suggest the facility manages substantial critical-care and observation caseloads tied to its emergency throughput rather than only low-acuity visits.

The provider reports exceptionally high volumes of infusion and IV administration services, with several administration codes flagged well above typical state volumes. Notably, 96361 (66K claims, $4.8M revenue) ranks #3 of 99 providers in-state (98th percentile; extreme outlier), and 96365 (36.2K claims, $2.5M revenue) ranks #3 of 100 (98th percentile; notably above typical), while 96372 (25.8K claims, $1.4M revenue) is #17 of 865 (98th percentile; extreme outlier). These patterns point to a large throughput of IV treatments and fluid/drug administrations—likely linked to ED, infusion center, and inpatient services.

Oncology and chemotherapy activity is present but mixed in competitive standing: J9271 (pembrolizumab) generates $7.1M (812 claims) and is ranked #5 of 9 in-state (50th percentile; typical), while chemotherapy code 96413 reports 8.4K claims and $1.7M in revenue (rank #7 of 48, 87th percentile). This indicates meaningful oncology/infusion therapy offerings, with pembrolizumab concentrated relative to a small set of peers but overall not an outlier in the state.

Diagnostic imaging and monitoring are significant components of the mix that support acute care and oncology workflows. Representative codes include 74177 (17.5K claims, $2.8M revenue, 94th percentile), 70450 (15.4K claims, $2.1M revenue, 91th percentile), 78815 (2.2K claims, $1.1M revenue, 95th percentile), 93306 (7.8K claims, $3.6M revenue, 88th percentile), and 93005 (46.4K claims, $2.5M revenue, 96th percentile). High volumes across CT, PET/CT, echo, and ECG without interpretation point to a robust imaging/diagnostics capacity aligned with the hospital’s ED and inpatient workload.

Competitive standing within the state is strong for several service lines: many top Medicaid codes rank in the 90th+ percentiles (for example, 99284 at the 96th percentile, 93005 at the 96th percentile, and multiple infusion codes at the 98th percentile), indicating the provider is a major in-state participant for ED, infusion/IV administration, and diagnostic services. At the same time, some specialty drug volumes like J9271 sit at median positions (50th percentile), so the provider’s dominance is concentrated in ED-driven and high-throughput procedural services rather than uniformly across all specialty therapies.

Medicaid: Complete Services Breakdown

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

597 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	70,390	$250	$17.6M
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.	48,160	$280	$13.6M
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	$190	$8.1M
J9271	Injection, pembrolizumab, 1 mg	810	$8,800	$7.1M
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.	65,990	$70	$4.8M
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…	7,820	$460	$3.6M
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	36,570	$80	$2.9M
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.	17,550	$160	$2.8M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	46,360	$60	$2.5M
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.	36,170	$70	$2.5M

Showing 1–10 of 597

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

Owensboro Health Inc — 8 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

597 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	5	10	810	$7,760	$8.7M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	127	310	830	$120	$3.7M
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.	12	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.	18	240	4,710	$150	$2.6M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	28	70	1,650	$100	$2M
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.	20	280	5,700	$120	$2M
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.	11	180	1,870	$280	$1.5M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	46	50	2,830	$90	$1.4M
G0378	Hospital observation service, per hour	6	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	9	30	2,320	$290	$1.2M

Showing 1–10 of 597

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Green River District Home Health	KY	Early Intervention Provider Agency	$0	$22.1M
Wendell Foster's Campus For Developmental Disabilities	KY	Comprehensive Outpatient Rehabilitation Facility (CORF)	$0	$19M
Puzzle Pieces, Inc.	KY	Community/Behavioral Health Agency	$0	$13.2M
Caretenders Vs Of Western Ky, LLC	KY	Home Health Agency	$0	$12.8M
Truenorth Treatment Center, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.8M
Community Alternatives Kentucky, Inc.	KY	Case Management Agency	$0	$9.5M
Owensboro Pediatrics LLC	KY	Pediatrics Physician	$0	$9.2M
Owensboro Health Medical Group, Inc	KY	Pediatrics Physician	$0	$7.4M
Green River District Health Dept	KY	Home Health Agency	$0	$7.2M
Owensboro Ambulatory Surgical Facility Ltd	KY	Ambulatory Surgical Clinic/Center	$1.3M	$4.8M

Owensboro Health 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

Nearby Providers

Frequently Asked Questions

References