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 1376540138)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sentara Hospitals
Address	2800 Godwin Blvd
City	Suffolk
State	VA
ZIP	23434
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 7, 2005

Payer Source	Total Paid
Medicaid	$57.9M
Medicare	$0

This provider is effectively a Medicaid-focused hospital: there is no Medicare billing on file while total Medicaid revenue is $57.9M, so the facility operates with a single-payer footprint in the available data rather than a mixed Medicare/Medicaid profile. Analysts should treat the entity as Medicaid-centric when evaluating payer exposure and revenue risk.

Revenue concentration is high: the top three Medicaid codes account for 51.6% of total Medicaid revenue, indicating over half of the $57.9M is driven by a small set of services. That degree of concentration suggests performance and reimbursement changes for those codes would materially impact the hospital's Medicaid revenue.

Emergency department E/M visits are the largest single revenue driver on Medicaid: code 99283 accounts for $11.2M (22.2% of Medicaid revenue) and code 99284 adds $8.2M (16.2%). The mix of 99283, 99284, and 99285 (together representing substantial shares) indicates a high-volume ED and acute unscheduled care orientation, with pressure on ED throughput and resources.

Operational profile reinforced by infusion and dehydration treatment codes: 96361 contributes $6.6M (13.2% of Medicaid revenue) and related IV/infusion codes 96360, 96365, and 96366 appear in the top-25 list. This combination signals frequent management of dehydration and parenteral therapies, consistent with an ED and observation unit that delivers IV fluids and prolonged infusions.

Competitive standing in the state is strong for several high-volume codes: the provider ranks #21 of 626 in-state for 99283 (97th percentile) and #27 of 620 for 99284 (96th percentile), which positions it as a major Medicaid provider of ED E/M services relative to peers. For additional services, ranks such as #11 of 90 for 96361 (89th percentile) and #10 of 214 for 94640 (96th percentile) further indicate above-typical state volume for infusion and respiratory treatments.

Several imaging and therapy services appear at moderate volumes: CT Abdomen/Pelvis with contrast 74177 ($2.4M, 4.7% of Medicaid revenue), CT head 70450 ($2.1M, 4.2%), and MRI and PT codes (70553, 72148, 97110) are present but at lower shares. These entries support a full-service acute care hospital with on-site diagnostic imaging and rehabilitation, but they are not the primary revenue drivers.

Service mix suggests reliance on acute episodic care rather than elective inpatient procedures: the prominence of ED E/M codes (99282–99285), observation hours (G0378), and short-term therapeutic/infusion codes points to high volumes of emergency and observation cases rather than coding dominated by major surgical DRGs or long inpatient stays. This has implications for operational focus areas such as ED staffing, infusion capacity, and observation-unit throughput.

The provider has long-tenure NPI enumeration: registered on 2005-07-07 (~21 years ago), indicating it is an established hospital in the market. That longevity, combined with above-typical Medicaid volumes for core ED and infusion services, suggests entrenched referral and utilization patterns in the regional Medicaid population.

Medicaid: Complete Services Breakdown

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

321 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.	68,910	$160	$11.2M
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.	53,110	$150	$8.2M
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.	24,370	$270	$6.6M
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.	31,790	$150	$4.8M
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.	20,260	$150	$3.1M
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…	49,330	$50	$2.5M
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.	13,810	$170	$2.4M
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.	12,850	$160	$2.1M
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	4,900	$230	$1.1M
G0378	Hospital observation service, per hour	4,230	$190	$783.3K

Showing 1–10 of 321

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 — 4 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

321 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.	11	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	23	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.	29	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.	21	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.	12	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	37	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.	27	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.	15	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…	149	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…	76	80	650	$210	$752.6K

Showing 1–10 of 321

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lovin Care Home Health Services, LLC.	VA	Home Health Agency	$0	$15.3M
Companion Of Care Home Health Inc.	VA	Home Health Agency	$0	$8.2M
Crossroads Treatment Center Of Suffolk, PC	VA	Methadone Clinic	$0	$7.8M
Miangel Home Healthcare, LLC	VA	Home Health Agency	$0	$7.4M
All For You In-home Care LLC	VA	Home Health Agency	$0	$7.3M
Safe Hands Home Health Care LLC	VA	VA Clinic/Center	$0	$6.3M
Heavenly Hands Inc	VA	In Home Supportive Care Agency	$0	$6.3M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$6.3M
Victor Archie	VA	Radiation Oncology Physician	$4M	$0
City Of Suffolk	VA	Ambulance	$955.1K	$2.1M

Sentara Hospitals — Billing Profile & Reimbursement Data

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Sentara Hospitals — 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

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	$78.5M
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