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

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

National Jewish Health (NPI 1326015777)

National Jewish Health is a general acute care hospital provider located in Denver, Colorado. This profile covers 0 Medicare and 125 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	National Jewish Health
Address	1400 Jackson St
City	Denver
State	CO
ZIP	80206
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 3, 2006

Payer Source	Total Paid
Medicaid	$7.7M
Medicare	$0

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

125 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	4,640	$430	$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…	38,910	$30	$1.2M
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	1,550	$410	$630.9K
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.	2,140	$220	$465.6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2,970	$130	$382.6K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	6,250	$60	$356.5K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	5,070	$60	$293.8K
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…	2,710	$90	$232.8K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	3,500	$50	$178.5K
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.	9,170	$20	$174.2K

Showing 1–10 of 125

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

National Jewish Health — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

125 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	771	2,520	330	$100	$352K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	4	30	80	$400	$301.9K
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…	51	80	830	$70	$274.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	11	100	110	$150	$271.5K
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…	29	2,630	430	$90	$268.2K
J2357	Injection, omalizumab, 5 mg	4	10	130	$1,000	$235.8K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	1	30	150	$320	$193.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	26	130	670	$50	$192.3K
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…	41	220	340	$60	$188.2K
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…	57	90	1,170	$20	$141.8K

Showing 1–10 of 125

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Brian Modena	CA	Allergy & Immunology Physician	$615.9K	$0
Robert Schreiner	CO	Rheumatology Physician	$303.9K	$0
Andrew Fisher	CO	Diagnostic Radiology Physician	$235.7K	$0
Louis Golden	CO	Diagnostic Radiology Physician	$219.7K	$500
Vernon Chapman	CO	Diagnostic Radiology Physician	$192.2K	$0
Mohamed Zaki Refaat	CO	Cardiovascular Disease Physician	$175.5K	$0
Stanislav Poliashenko	CO	Diagnostic Radiology Physician	$167.3K	$0
Jean Michel Grillon	CO	Diagnostic Radiology Physician	$163.3K	$0
Jared Mahan	CO	Diagnostic Radiology Physician	$161.1K	$0
Andrew Olsen	CO	Diagnostic Radiology Physician	$159.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Denver Recovery Group LLC	CO	Methadone Clinic	$287.7K	$22.8M
Madison Street Surgery Center, LLC	CO	Ambulatory Surgical Clinic/Center	$699.2K	$635.9K
Uchealth Ambulatory Surgery Centers	CO	Ambulatory Surgical Clinic/Center	$346.1K	$46.4K
Denver Mid-town Surgery Center Ltd	CO	Ambulatory Surgical Clinic/Center	$104.4K	$189.9K
Jason Wang	CO	Ophthalmology Physician	$280.7K	$0
Howard Amiel	CO	Ophthalmology Physician	$237.9K	$0
Nina Casanova	CO	Urology Physician	$217.9K	$0
Cher, LLC	CO	Diagnostic Radiology Physician	$178.4K	$25.6K
Gary Belen	CO	Specialist	$186.8K	$0
Elizabeth De	CO	Internal Medicine Physician	$180.7K	$0

National Jewish Health — Billing Profile & Reimbursement Data

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National Jewish Health — 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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