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.

Cleveland Clinic Mercy Hospital (NPI 1366433195)

Key Findings

Field	Value
Entity Type	Organization
Organization	Cleveland Clinic Mercy Hospital
Address	1320 Mercy Dr Nw
City	Canton
State	OH
ZIP	44708
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 1, 2005

Payer Source	Total Paid
Medicaid	$86.8M
Medicare	$0

CLEVELAND CLINIC MERCY HOSPITAL appears to operate effectively as a Medicaid-focused provider: it has no Medicare billing on file and reports Total Medicaid revenue: $86.8M. The absence of Medicare revenue makes its financial footprint here effectively single-payer (Medicaid) in the claims data available, which concentrates risk and reimbursement exposure to state Medicaid rules and rates.

Revenue concentration is high: the precomputed top three Medicaid codes account for 44.7% of the provider's total Medicaid revenue. Those top contributors are G0463 ($17.8M, 24.8%), 99213 ($7.8M, 10.9%), and 96361 ($6.4M, 9.0%), with G0463 alone responsible for nearly a quarter of Medicaid dollars at this provider.

The code mix points to a large hospital outpatient clinic and ambulatory evaluation-and-management operation: G0463 (hospital outpatient clinic visit) is the largest single revenue driver, and E/M office visit codes 99213, 99212, 99214, and new-patient codes like 99202 appear prominently. High counts and payments for 99213 (118.4K claims, $66 avg paid/claim, $7.8M) and 99212 (43.7K claims, $102 avg paid/claim, $4.5M) indicate heavy ambulatory patient throughput and substantial reliance on clinic visit volume.

Emergency care and IV/infusion services are a material part of the clinical footprint: ED E/M codes 99285 (49.3K claims, $129 avg, $6.4M), 99284 (48.4K claims, $116 avg, $5.6M), and 99283 (42.4K claims, $108 avg, $4.6M) collectively contribute significant revenue, while infusion/dehydration codes such as 96361 (20.9K claims, $307 avg, $6.4M) and related 96365/96360/96366 entries show routine administration of IV fluids and infusions. This mix suggests both a busy ED and frequent use of IV therapy for dehydration and medication administration.

Imaging, diagnostics, and ancillary services support the clinical volume: CT head 70450 ($2.7M) and CT abdomen/pelvis 74177 ($2.0M) appear in the top-25, and lab panels 80053 (58.5K claims, $13 avg, $761K) and 80048 (65.1K claims, $8 avg, $520.9K) show sizable lab throughput. Proprietary and COVID testing codes such as 0202U ($452.5K) and U0003 ($809.3K) further indicate in‑house or closely affiliated lab capability driving ancillary Medicaid revenue.

Competitive standing is uneven by service line: the provider ranks highly in ambulatory visit volume statewide — 99213 ranks #48 of 5077 providers in-state (99th percentile, notably above typical state volume) and 99212 ranks #10 of 1608 (99th percentile, labeled an "extreme outlier"). G0463 ranks #9 of 151 in-state (95th percentile) which is elevated but characterized as typical volume for that code among hospital clinic peers. By contrast, several imaging and observation codes sit in high-but-not-dominant percentiles (e.g., 70450 at the 89th percentile and G0378 at the 77th percentile), implying the hospital is a major ambulatory/E&M player in the state while being more typical among hospitals for imaging and observation.

The facility is an established entity with long tenure: NPI enumerated (registered) on 2005-11-01 (~21 years ago), indicating two decades of presence in the market. Combined with $86.8M in Medicaid revenue and no Medicare billing on file, the data portray a mature, Medicaid-centric hospital that drives revenue primarily through outpatient clinic visits, E/M services, ED encounters, and IV/infusion therapy rather than Medicare hospital billing channels.

Medicaid: Complete Services Breakdown

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

574 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	191,370	$90	$17.8M
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…	118,440	$70	$7.8M
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.	20,920	$310	$6.4M
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.	49,300	$130	$6.4M
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.	48,380	$120	$5.6M
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.	42,380	$110	$4.6M
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	43,740	$100	$4.5M
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…	39,610	$70	$2.7M
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.	11,340	$240	$2.7M
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.	8,570	$230	$2M

Showing 1–10 of 574

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

Cleveland Clinic Mercy Hospital — 6 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

574 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9	150	4,030	$100	$5.9M
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.	16	170	4,660	$300	$2.6M
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.	70	480	4,510	$90	$1.8M
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.	60	660	460	$90	$1.5M
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.	37	580	510	$100	$1.3M
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…	19	140	1,130	$90	$1.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	11	30	520	$820	$994.5K
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…	71	80	910	$110	$884.9K
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…	22	50	310	$110	$817.2K
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.	31	290	1,380	$90	$635.2K

Showing 1–10 of 574

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Partners Physician Group	OH	Surgery Physician	$0	$28.5M
Wooster Clinic, LLC	OH	Multi-Specialty Clinic/Center	$0	$6.9M
Clinic Medical Services Company	OH	Diagnostic Radiology Physician	$410.1K	$0
Nagaraja Oruganti	OH	Gastroenterology Physician	$211K	$0
Brett Butler	OH	Vascular Surgery Physician	$158.3K	$0
Jeffrey Prem	OH	Vascular Surgery Physician	$132.4K	$0
Mathew Miller	OH	Vascular Surgery Physician	$129.1K	$0
Jason Abdallah	OH	Gastroenterology Physician	$100.2K	$0
Vincent Sudimak	OH	Surgery Physician	$78.4K	$0
Kent Ramsey	OH	Otolaryngology Physician	$54.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$29.4M
Steel Valley Diversified, Inc	OH	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	$1.7M	$3.4M
Kevin Wietecha	OH	Endocrinology, Diabetes & Metabolism Physician	$297K	$2.8K
Dayanand Makey	OH	Nephrology Physician	$285.7K	$0
Anthony Degenhard	OH	Nephrology Physician	$262K	$0
Bhavnish Bucktowarsing	OH	Nephrology Physician	$230.2K	$0
Pramod Bhargava	OH	Nephrology Physician	$227.5K	$0
John Garton	OH	Nephrology Physician	$215.7K	$0
Aida Safar	OH	Anatomic Pathology & Clinical Pathology Physician	$185.5K	$0
Michelle Baker	OH	Physical Therapist	$169.2K	$0

Cleveland Clinic Mercy Hospital — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References