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

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

Mount Carmel Healthproviders Inc (NPI 1356384143)

Mount Carmel Healthproviders Inc is a family medicine physician provider located in Columbus, Ohio. This profile covers 0 Medicare and 65 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	Mount Carmel Healthproviders Inc
Address	6150 E Broad St
City	Columbus
State	OH
ZIP	43213
Taxonomy	Family Medicine Physician
NPI Enumerated	June 13, 2006

Payer Source	Total Paid
Medicaid	$9.5M
Medicare	$0

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

65 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	134,950	$50	$7M
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…	48,930	$40	$1.8M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,010	$60	$120.4K
99204	The provider sees a new 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 provider…	1,530	$80	$116.1K
99203	The provider sees a new 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 provider…	1,140	$50	$60.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,920	$10	$50.9K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	3,130	$20	$47K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	2,550	$20	$43.4K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	480	$60	$29.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,210	$20	$26.7K

Showing 1–10 of 65

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Mount Carmel Healthproviders Inc — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

65 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	30	4,510	500	$60	$377.8K
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…	134	5,080	560	$40	$323.9K
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…	228	430	560	$60	$303.2K
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…	287	480	450	$70	$292.9K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	229	270	420	$90	$276K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	396	480	280	$70	$181.7K
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…	285	600	480	$30	$132.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	115	1,030	180	$90	$127K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	376	920	640	$20	$114.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	363	440	190	$70	$110.5K

Showing 1–10 of 65

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$66.7M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$42.4M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$14.4M
Trinity Home Health Services	OH	Community Based Hospice Care Agency	$0	$8.9M
Kelleen Graver	OH	Nurse Practitioner	$2.1M	$0
Mount Carmel Health System	OH	Sleep Disorder Diagnostic Clinic/Center	$73.8K	$402.6K
Thomas Archer	OH	Cardiovascular Disease Physician	$417.9K	$0
Ken Lee	FL	Clinical Cardiac Electrophysiology Physician	$369K	$0
Joel Politi	OH	Orthopaedic Surgery Physician	$351.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lighthouse Behavioral Health Solutions, LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$116.4M
Access Ohio, LLC	OH	Community/Behavioral Health Agency	$0	$72.4M
Independent Home Care Inc.	OH	Home Health Agency	$0	$47.5M
The Buckeye Ranch, Inc	OH	Adolescent and Children Mental Health Clinic/Center	$0	$32.5M
Caring Heart Home Health Agency LLC	OH	Home Health Agency	$0	$24.3M
Golden Rule Home Health Care LLC	OH	Home Health Agency	$0	$13.8M
Columbia Home Health Care Inc	OH	Home Health Agency	$0	$11.7M
Alta Home Health Care, LLC	OH	Home Health Agency	$0	$10.4M
Hospitalist Medicine Physicians Of Ohio, Professional Corporation	OH	Internal Medicine Physician	$0	$9.7M
Lifesaver Health Care, LLC	OH	Home Health Agency	$0	$9.6M

Mount Carmel Healthproviders 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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