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

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

Riverside University Health Systems - Medical Center (NPI 1386852416)

Field	Value
Entity Type	Organization
Organization	Riverside University Health Systems - Medical Center
Address	26520 Cactus Ave
City	Moreno Valley
State	CA
ZIP	92555
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 21, 2007

Payer Source	Total Paid
Medicaid	$123.6M
Medicare	$0

Key Findings

RIVERSIDE UNIVERSITY HEALTH SYSTEMS - MEDICAL CENTER is effectively a single-payer facility in these data because it has no Medicare billing on file while reporting $123.6M in Medicaid revenue; the absence of any Medicare claims suggests the dataset captures the hospital’s activity primarily through Medicaid encounters rather than a mixed Medicare/Medicaid payer mix. This concentration means analyses of inpatient and outpatient volumes for this site should focus on Medicaid patterns rather than Medicare comparators.

Medicaid revenue is concentrated in a relatively small set of high-value codes: the precomputed top three Medicaid codes account for 33.9% of the provider’s total Medicaid revenue, indicating one-third of its reported Medicaid dollars come from a narrow set of services. That level of concentration implies business sensitivity to utilization and reimbursement on those leading codes and suggests monitoring those code volumes for revenue risk.

The provider’s code mix shows a broad acute-care hospital footprint with high volumes of emergency department and outpatient clinic activity: 99283 (ED E/M, 102K claims) and G0463 (hospital outpatient clinic visit, 154.3K claims) are both large contributors to revenue and rank in the 99th percentile for in-state peers, which aligns with a busy tertiary or regional acute care center managing heavy ED and clinic throughput. High use of imaging and diagnostic codes such as 74177 (CT abdomen/pelvis), 70450 (CT head), 70553 (brain MRI), 93975 (abdominal duplex ultrasound), and 78815 (PET/CT) further indicates substantial on-site radiology and advanced imaging capacity supporting acute and oncologic care.

Riverside is a dominant in-state provider for several high-revenue services: 93975 ranks #1 of 226 providers (100th percentile) and several encounter and diagnostic codes (e.g., 99283 at the 99th percentile; G0463 at the 99th percentile; Z7502 at the 99th percentile) are described as extreme outliers or far above typical state volume. These rankings point to the hospital being a major regional hub for emergency care, outpatient clinic visits, vascular imaging, and certain high-throughput diagnostic services within California’s Medicaid network.

The hospital also reports substantial revenue from expensive drug administrations and specialty infusions: J9271 (pembrolizumab) generated $10.9M (16.8% of Medicaid revenue) and J1568 (IV immune globulin) generated $2.2M (3.3%); high average paid/claim values for codes such as J9271 ($11455) and J1568 ($1990) indicate meaningful oncology and immunologic treatment lines on site, while J9312 (rituximab) and J0490 (belimumab) further support active specialty infusion services. These specialty drug lines are significant revenue drivers and align with the hospital’s advanced imaging and inpatient/ED volumes.

Volume metrics for routine lab, monitoring, and therapy services are also elevated: 80053 (CMP, 138.5K claims), 85025 (CBC, 146.4K claims), 93005 (ECG recording, 59.4K claims), and 97110 (therapeutic exercise, 83.8K claims) all appear in the top codes and rank at or near high percentiles in-state. This combination signals robust ancillary service throughput (laboratory, cardiac monitoring, and physical therapy) consistent with a large acute-care facility handling high patient flow across inpatient, ED, and outpatient settings.

Several codes show unusually high claim volumes without clear descriptions (0450, 0510, 0360, 0121, Z7502 listed as no/unspecified descriptions or non-specific codes) but together contribute materially to revenue (e.g., 0450: $6.3M, 0510: $2.3M, Z7502: $2.0M). Many of these rank in high percentiles statewide, so they represent substantial service lines or billing buckets for this hospital; analysts should map these unspecified codes to internal service categories to understand operational drivers.

Provider tenure is long-standing: the NPI was enumerated ~19 years ago (2007-05-21), indicating this facility has been active in national provider registries for nearly two decades. That tenure, paired with the large Medicaid footprint and high-volume rankings, supports the interpretation of an established regional medical center with sustained Medicaid activity and developed clinical service lines.

While many high-volume codes are typical for a large hospital, a number of codes are flagged as extreme outliers in the state (for example 99283, G0463, 93975, Z7502, and 93005); these outlier designations suggest the facility’s operational profile and case mix differ substantially from most in-state peers, and payers or network managers should treat comparisons to statewide averages cautiously when assessing utilization or contract performance.

Medicaid: Complete Services Breakdown

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

670 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	960	$11,460	$10.9M
0450	N/A	133,330	$50	$6.3M
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.	102,040	$50	$4.9M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	154,250	$20	$3.5M
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	18,730	$170	$3.1M
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.	15,220	$180	$2.7M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	138,530	$20	$2.5M
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.	15,910	$150	$2.4M
0510	N/A	206,230	$10	$2.3M
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…	83,790	$30	$2.3M

Showing 1–10 of 670

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Riverside University Health Systems - Medical Center — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

670 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	30	450	16,140	$90	$3.6M
J9271	Injection, pembrolizumab, 1 mg	11	60	240	$4,460	$3.4M
0121	N/A	27	70	130	$4,600	$2.6M
J2505	Injection, pegfilgrastim, 6 mg	15	30	220	$2,310	$1.2M
J9355	Injection, trastuzumab, excludes biosimilar, 10 mg	20	20	260	$2,370	$1.2M
0206	N/A	34	40	80	$2,760	$1.1M
J0178	Injection, aflibercept, 1 mg	69	120	380	$970	$1.1M
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.	17	1,570	680	$110	$1.1M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	14	40	200	$1,990	$1M
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.	390	1,300	510	$100	$943K

Showing 1–10 of 670

Nearby Providers

Other providers in the same ZIP code as Riverside University Health Systems - Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cep America - California	CA	Emergency Medicine Physician	$0	$32.7M
Kaiser Foundation Hospitals	CA	General Acute Care Hospital	$0	$26.3M
Benjamin Smith	CA	Orthopaedic Surgery of the Spine Physician	$209.6K	$0
Yasaman Safarpour	CA	Internal Medicine Physician	$52.9K	$0

Riverside University Health Systems - Medical Center — Billing Profile & Reimbursement Data

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Riverside University Health Systems - Medical Center — 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

Nearby Providers

Frequently Asked Questions

References