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

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

Sentara Hospitals (NPI 1336109107)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sentara Hospitals
Address	3000 Coliseum Dr
City	Hampton
State	VA
ZIP	23666
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 25, 2006

Payer Source	Total Paid
Medicaid	$78.5M
Medicare	$0

SENTARA HOSPITALS in HAMPTON, VA reports no Medicare billing on file and therefore all documented federal fee-for-service revenue in this dataset is concentrated in Medicaid, totaling $78.5M; this makes the provider effectively single-payer (Medicaid) in the available claims data and exposes its financial performance to Medicaid utilization and policy changes.

Revenue concentration is high: the precomputed top-three Medicaid codes (99283, 99284, 96361) account for 59.4% of the provider's total Medicaid revenue, indicating that a majority of Medicaid dollars flow through a small set of services rather than a broad, even mix of specialties.

Clinical and service-line profile is emergency-department centric. The largest single Medicaid revenue line is 99283 ($20.8M, 129K claims, $161 avg paid/claim), and the code mix includes high volumes of 99282 ($6.5M, 41.5K claims), 99284 ($11.5M, 71K claims) and 99285 ($5.4M, 32.4K claims), which together point to a hospital operating with substantial ED throughput handling straightforward to moderate-complexity E/M visits and some higher-complexity cases.

The provider is a statewide leader on several ED-related codes: 99283 ranks #4 of 626 providers in-state (100th percentile; extreme outlier) and 99282 ranks #2 of 139 providers (99th percentile; extreme outlier), signaling unusually large ED volumes relative to peers; 99284 is also notably above typical state volume (rank #16 of 620, 98th percentile).

SENTARA shows elevated use of infusion and supportive care services tied to acute presentations: 96361 ($8.5M, 30.6K claims) ranks #8 of 90 providers in-state (92th percentile; notably above typical), and related infusion codes 96360, 96365 and 96366 also appear in the top lines. Combined with frequent 94640 oxygen therapy (14.8K claims, $634.5K revenue, rank #4 of 214, 99th percentile; extreme outlier), this suggests a case-mix featuring dehydration, IV therapy, and acute respiratory interventions.

Imaging and therapy services contribute meaningfully but are secondary to ED/infusion activity: CT and MRI codes (74177, 70450, 74176, 71275, 70553) and therapy codes (97110, 97112, 97161, 97162, 97530) appear across the top 25, generally at 70–96th percentiles and described as typical or notably above typical state volumes rather than extreme outliers, indicating a broad hospital service portfolio supporting acute care.

Competitive standing is mixed by service line: the hospital is a dominant outlier for certain ED and supportive-care codes (e.g., 99283 and 99282 are extreme outliers at the state level), while many imaging and rehab codes rank in the mid-to-high percentiles but are characterized as typical or only notably above typical—consistent with a facility that concentrates market share in emergency throughput but operates within the expected range for ancillary services.

The provider has an established tenure in the dataset, with its NPI enumerated on 2006-03-25 (approximately 20 years ago), indicating long-standing operation in the market which may contribute to its entrenched ED volumes and state-level rank positions for several high-volume Medicaid codes.

Medicaid: Complete Services Breakdown

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

341 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	128,990	$160	$20.8M
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.	71,000	$160	$11.5M
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.	30,640	$280	$8.5M
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.	41,480	$160	$6.5M
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.	32,440	$170	$5.4M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	45,570	$50	$2.3M
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.	10,870	$190	$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.	10,270	$190	$1.9M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	7,870	$180	$1.4M
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.	4,340	$170	$754.6K

Showing 1–10 of 341

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Sentara Hospitals — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

341 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	8	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16	70	3,200	$110	$2.8M
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.	28	340	160	$130	$1.3M
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.	4	630	90	$140	$1.1M
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.	2	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	57	80	3,650	$160	$1M
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.	16	620	70	$120	$1M
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.	25	180	2,950	$140	$783.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	86	260	3,950	$80	$769.6K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	59	80	650	$210	$752.6K

Showing 1–10 of 341

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hampton Newport News Community Services Board	VA	Community/Behavioral Health Agency	$0	$123.8M
Serenity C & C Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$74.2M
Agape Counseling & Therapeutic Services, Inc	VA	Community/Behavioral Health Agency	$0	$18.5M
Alliance Behavioral Counseling	VA	Community/Behavioral Health Agency	$0	$16.9M
Hampton Mental Health Associates, Inc	VA	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
United And Empowered Care, Inc	VA	Developmentally Disabled Services Day Training Agency	$0	$11.8M
Better Life Services, Inc.	VA	Community/Behavioral Health Agency	$0	$9.2M
Creating Scholars Through Therapy, LLC	VA	Community/Behavioral Health Agency	$0	$7.6M
Key Elements Care, LLC	VA	In Home Supportive Care Agency	$0	$6.8M
Ullc,inc.	VA	Developmentally Disabled Services Day Training Agency	$0	$6.1M

Sentara Hospitals — Billing Profile & Reimbursement Data

Sign up for Sentara Hospitals — Billing Profile & Reimbursement Data policy alerts

Sentara Hospitals — Billing Profile & Reimbursement Data

Sign up for Sentara Hospitals — Billing Profile & Reimbursement Data policy alerts

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$88M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$79.7M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$57.9M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$52.3M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$21.9M
Sentara Hospitals	VA	Air Ambulance	$977.3K	$170.6K
Michele Henry	VA	Chiropractor	$16.7K	$0