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.

Bethesda Hospital Inc (NPI 1396714663)

Field	Value
Entity Type	Organization
Organization	Bethesda Hospital Inc
Address	10500 Montgomery Rd
City	Cincinnati
State	OH
ZIP	45242
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 17, 2006

Payer Source	Total Paid
Medicaid	$57M
Medicare	$0

Key Findings

This facility is effectively a Medicaid-centric hospital: there is no Medicare billing on file while total reported Medicaid revenue is $57M, indicating the provider’s commercial/Medicare exposure is minimal or absent in the available data. For analyst purposes this means Medicaid policy, rates, and network design will largely determine its reimbursement profile rather than Medicare dynamics.

Revenue is highly concentrated in a small set of emergency and infusion services: the precomputed top-3 Medicaid codes account for 58.7% of the provider’s Medicaid revenue, driven by 99283, 99284, and 96361. That concentration signals operational reliance on high ED throughput and IV/infusion care as the primary revenue engines.

The code mix indicates a high-volume emergency department and acute-care throughput: 99283 (ED E/M, low complexity) is the single largest Medicaid revenue code at $11M (25.8% of Medicaid revenue) and ranks notably above typical state volume (95th percentile). Complementary ED codes 99284 and 99285 also appear in the high-revenue list, supporting an inference that emergency services are a core service line.

Infusion and procedural acute-care activity is material: 96361 (IV fluids with electrolytes for additional hours) contributes $5.9M (13.9% of Medicaid revenue) and ranks in the 88th percentile in-state, indicating consistent use of prolonged IV therapy or dehydration treatment in the patient mix. Additional infusion-related codes such as 96365 and oxygen/airway-related code 94640 further corroborate ongoing procedural and acute respiratory care.

Imaging and diagnostics support the acute-care profile: high-revenue imaging codes like 74177 and 70450 (CT abdomen/pelvis with contrast; CT head without contrast) and lab panels such as 80053, 84443, and infectious tests like 87491 feature in the top Medicaid codes. These diagnostic volumes (many in the 70th–90th state percentile range) imply the hospital maintains on-site CT and laboratory capacity consistent with a general acute care operation.

There are clear statistical outliers in specific services that may reflect specialized or concentrated practice lines: 0241U ranks #4 of 88 providers in-state (97th percentile) and is described as notably above typical state volume, while 99283 also sits at the 95th percentile. Separately, 58661 (laparoscopic removal of ovaries/tubes) ranks #2 of 20 providers in-state (95th percentile), suggesting relatively high Medicaid surgical OB/GYN activity compared with peers.

Competitive standing is mixed by service line: for core ED workload the provider ranks highly versus in-state peers (for example 99283 at the 95th percentile), indicating a dominant regional presence for lower-complexity ED visits, but many other frequent codes (e.g., 99284, 96361, common labs) are in the 70th–90th percentile where volume is typical or unremarkable relative to the state. Analysts should consider this as a hospital that is a major ED volume center for certain visit types but otherwise a conventional acute-care provider across diagnostics and routine procedures.

The provider has longstanding enrollment: its NPI was enumerated on 2006-03-17 (~20 years ago), indicating an established operating history in the market. Combined with the Medicaid concentration and the ED-centric revenue mix, this tenure supports a stable operating footprint that is likely important for Medicaid network adequacy and emergency access planning.

Medicaid: Complete Services Breakdown

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

452 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.	90,500	$120	$11M
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.	59,010	$140	$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.	18,950	$310	$5.9M
0241U	N/A	15,660	$130	$2.1M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	11,200	$130	$1.5M
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…	11,850	$120	$1.4M
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.	5,830	$240	$1.4M
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.	5,300	$210	$1.1M
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.	9,350	$120	$1.1M
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.	40,710	$20	$895.6K

Showing 1–10 of 452

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

Bethesda Hospital Inc — 2 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

452 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	111	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.	20	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.	26	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.	46	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.	153	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…	46	140	1,130	$90	$1.1M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	47	80	100	$860	$719.1K
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.	70	290	1,380	$90	$635.2K
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.	53	280	1,110	$110	$605.7K
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.	62	230	2,200	$100	$530.1K

Showing 1–10 of 452

Related Providers

Other providers that share a Tax Identification Number (TIN) with Bethesda Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Trihealth G LLC	OH	Internal Medicine Physician	$0	$31M

Nearby Providers

Other providers in the same ZIP code as Bethesda Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$63.6M
Hospice Of Cincinnati Incorporated	OH	Community Based Hospice Care Agency	$0	$54M
Carestar, Inc.	OH	Case Management Agency	$0	$43.1M
Counseling Source Inc	OH	Mental Health Counselor	$0	$41M
Mercy Health Physicians Cincinnati, LLC	OH	Family Medicine Physician	$0	$27.9M
Qualified Emergency Specialists Inc	OH	Emergency Medicine Physician	$0	$18.9M
Crossroads Hospice Of Cincinnati	OH	Community Based Hospice Care Agency	$0	$14.6M
A Best Home Care,inc.	OH	Home Health Agency	$0	$10.4M
Cei Physicians Psc LLC	OH	Ophthalmology Physician	$0	$8.5M
Mercy Health Physicians Cincinnati Specialty Care LLC	OH	Surgery Physician	$0	$7.1M

Bethesda Hospital Inc — 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