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

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

Saint Elizabeth Regional Medical Center (NPI 1336155738)

Key Findings

Field	Value
Entity Type	Organization
Organization	Saint Elizabeth Regional Medical Center
Address	555 S 70th St
City	Lincoln
State	NE
ZIP	68510
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 31, 2006

Payer Source	Total Paid
Medicaid	$14.9M
Medicare	$0

SAINT ELIZABETH REGIONAL MEDICAL CENTER is effectively a single-payer facility in the available data: there is no Medicare billing on file and lifetime Medicaid revenue is $14.9M, so Medicaid dominates all recorded public-payer activity for this provider. This concentration means any population- or payment-policy changes to Medicaid will have outsized revenue impact on the facility.

Revenue is highly concentrated in a few emergency and infusion-related codes: the top three Medicaid codes (99283, 99284, 96361) account for 55.5% of the provider's total Medicaid revenue, with 99283 alone generating $3.6M (28.0%) and 99284 generating $2.6M (20.5%). That level of concentration indicates that a small number of service lines drive the majority of reported Medicaid dollars.

The code mix points to a high-volume emergency department and acute medical management orientation. Multiple E/M ED codes appear near the top of the payer mix (99283 $3.6M, 99284 $2.6M, 99285 $726.2K, 99282 $294.1K) alongside frequent IV/infusion codes (96361 $907.2K, 96365 $260.1K, 96366 $176.9K), imaging (74177 $763K, 70450 $486.9K), and wound care/debridement (11042 $435.5K), which together suggest routine ED throughput with on-site imaging and acute treatment resources.

Competitive standing within the state is strongest in several ED and procedure lines: 99283 ranks #8 of 139 providers in-state at the 95th percentile and is explicitly labeled "notably above typical state volume," while 99284 sits at the 89th percentile (#13 of 112) and 96361 is in a high state percentile (rank #8 of 37). Other codes with elevated standing include 0241U (rank #3 of 39, 95th percentile, "notably above typical state volume") and 11042 (rank #2 of 17, 94th percentile, "notably above typical state volume"). These rankings indicate the hospital is a major in-state provider for specific ED services and select procedures, even if many other codes show typical, unremarkable volumes.

Service breadth reflects typical general acute care operations beyond the ED: significant CT imaging (74177 $763K, 70450 $486.9K), obstetric fetal monitoring interpretation (59050 $234.1K, ranked #1 of 4, 100th percentile but labeled "typical, unremarkable volume"), and diagnostic ultrasound (76700 $82.7K, 76856 $101K) suggest capability for inpatient and obstetric workups in addition to emergency care. The presence of G0378 observation hours ($194K) supports an on-site observation/short-stay capability tied to ED throughput.

Operationally, frequent use of infusion and supportive-care codes signals routine acute medical treatments: 96361 ($907.2K, 7.1%), 96365 ($260.1K, 2.0%), 96366 ($176.9K, 1.4%), and 94640 ($171.7K, 1.3%) together reflect ongoing demand for IV therapies and respiratory interventions typical of an ED and short-stay inpatient environment. Payers and network managers should interpret these as indicators of steady acute-care service demand rather than isolated high-cost procedures.

The provider's NPI was enumerated on 2006-07-31 (~20 years ago), indicating long-tenured active billing at the organizational level; this longevity supports interpretation of reported patterns as established service lines rather than temporary spikes. The historical presence may also mean existing payer relationships and referral patterns are well established in the local market.

For payers and contracting analysts, the combination of no Medicare billing and a Medicaid revenue base concentrated in ED E/M and infusion codes (top three codes = 55.5%) suggests focus areas for utilization management and rate negotiations should be emergency department throughput, observation use (G0378 $194K), and high-volume infusion services. These are natural levers to influence total Medicaid spend with this provider given the limited payer diversity in the available data; the patterns described are operationally oriented observations rather than assertions about coding intent.

Medicaid: Complete Services Breakdown

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

220 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.	24,440	$150	$3.6M
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.	18,670	$140	$2.6M
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.	4,110	$220	$907.2K
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.	2,310	$330	$763K
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.	4,690	$160	$726.2K
0241U	N/A	5,470	$120	$661.3K
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.	2,150	$230	$486.9K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	3,250	$130	$435.5K
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.	3,460	$90	$294.1K
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.	2,580	$100	$260.1K

Showing 1–10 of 220

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Saint Elizabeth Regional Medical Center — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

220 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	13	110	770	$110	$774.3K
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	40	820	$260	$734.1K
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.	8	140	1,100	$110	$607.4K
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.	13	80	300	$120	$519.5K
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.	12	50	820	$160	$461.3K
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…	32	40	350	$170	$366.6K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	15	20	270	$260	$342.4K
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…	320	700	660	$70	$305.1K
G0378	Hospital observation service, per hour	8	30	950	$120	$276.4K
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.	13	50	830	$90	$269K

Showing 1–10 of 220

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Monica's	NE	Substance Abuse Rehabilitation Facility	$0	$7.1M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$3.9M
Centerpointe, Inc.	NE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.7M
Bluestem Health	NE	Federally Qualified Health Center (FQHC)	$0	$3.6M
Lincoln Medical Education Partnership	NE	Family Medicine Physician	$0	$3.2M
Hopespoke	NE	Community/Behavioral Health Agency	$0	$2.9M
Lincoln-lancaster County Health Department	NE	Public Health or Welfare Agency	$0	$2.7M
Chi Health Clinic Specialty, LLC	NE	Hospitalist Physician	$0	$2.6M
Eyes On Lincoln	NE	Optometrist	$0	$2.6M
Heartland Urgent Care LP	NE	Urgent Care Clinic/Center	$0	$2.5M

Saint Elizabeth Regional Medical Center — Billing Profile & Reimbursement Data

Sign up for Saint Elizabeth Regional Medical Center — Billing Profile & Reimbursement Data policy alerts

Saint Elizabeth Regional Medical Center — Billing Profile & Reimbursement Data

Sign up for Saint Elizabeth Regional Medical Center — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References