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.

Summa Health System (NPI 1396765681)

Field	Value
Entity Type	Organization
Organization	Summa Health System
Address	525 E Market St
City	Akron
State	OH
ZIP	44304
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 20, 2006

Payer Source	Total Paid
Medicaid	$170.6M
Medicare	$0

Key Findings

SUMMA HEALTH SYSTEM reports no Medicare billing on file and is effectively a single-payer (Medicaid) billing entity at scale, with $170.6M in lifetime Medicaid revenue recorded. This asymmetric payer mix means analyses of utilization and contracting should be driven by Medicaid patterns rather than Medicare comparators.

Revenue concentration is high: the top three Medicaid codes account for 45.5% of the provider's total Medicaid revenue. Those top drivers are G0463 (17.6% of Medicaid revenue, 258.6K claims, $22.5M revenue, ranks #6 of 151 in-state at the 97th percentile), 96361 (14.0%, 62.2K claims, $17.9M revenue, ranks #3 of 165 in-state and is an extreme outlier), and 99284 (13.9%, 129.9K claims, $17.8M revenue, ranks #19 of 655 in-state at the 97th percentile).

The code mix points to a hospital operating model centered on high ED throughput, frequent IV/infusion services, and substantial outpatient clinic activity. Multiple high-volume ED codes (99283: 147.8K claims; 99284: 129.9K claims; 99285: 73.5K claims) plus observation (G0378: 35.7K claims) and numerous infusion codes (96365, 96360, 96361, 96366) indicate the system runs heavy emergency, observation, and infusion workflows tied to inpatient/ED demand.

SUMMA is a statewide leader for several specific services: 96361 is an extreme outlier (rank #3 of 165, 99th percentile) and 96360 ranks #2 of 145 (99th percentile), showing dominant IV fluid/infusion activity relative to peers. Other extreme outlier standings include 90853 (group psychotherapy, rank #3 of 485, 100th percentile), 43239 (EGD biopsy, rank #4 of 280, 99th percentile), 45385 (therapeutic colonoscopy, rank #4 of 146, 98th percentile), and 47562 (laparoscopic cholecystectomy, rank #1 of 23, 100th percentile), which together suggest leadership in behavioral health group therapy, endoscopy, and select surgical procedures.

Operational scale is reflected in very large claim volumes for core codes: G0463 has 258.6K claims and 80053 (CMP) has 131.5K claims, while ED-level codes report tens to hundreds of thousands of visits (e.g., 99283 at 147.8K claims, 99284 at 129.9K claims). These volumes imply substantial ED and outpatient clinic throughput with commensurate staffing, bed-flow, and ancillary-service requirements.

While infusion activity and ED visits drive the bulk of revenue, high-cost oncology drug use appears limited relative to those lines: J9271 (pembrolizumab) generates $2.2M (1.7% of Medicaid revenue) from 228 claims and ranks #13 of 22 in-state at the 43rd percentile, indicating some oncology infusion services but not a major revenue focus compared with the dominant ED/infusion mix.

Observation and short-stay services are meaningfully used alongside ED care: G0378 (hospital observation service) accounts for 35.7K claims and $2.9M in revenue and ranks #7 of 155 (96th percentile), which supports the interpretation of an ED-to-observation throughput model rather than primary reliance on prolonged inpatient admissions. Payers should note this when modeling length-of-stay and observation-payment exposure.

SUMMA's NPI was enumerated on 2006-07-20 (~20 years ago), indicating long-standing in-state presence. Combined with the provider's concentrated Medicaid revenue and the pattern of high-volume ED, observation, and infusion services, this tenure suggests an established role in the local Medicaid network that payers may treat as a major Medicaid-serving system for Akron and surrounding areas.

Medicaid: Complete Services Breakdown

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

673 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	258,590	$90	$22.5M
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.	62,160	$290	$17.9M
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.	129,910	$140	$17.8M
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.	147,750	$120	$17.4M
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.	73,480	$160	$11.7M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	82,000	$60	$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.	14,070	$270	$3.8M
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.	13,060	$260	$3.4M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	7,330	$410	$3M
G0378	Hospital observation service, per hour	35,710	$80	$2.9M

Showing 1–10 of 673

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

Summa Health System — 17 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

673 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	6	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	13	20	360	$8,480	$5M
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.	3	170	4,660	$300	$2.6M
J9299	Injection, nivolumab, 1 mg	7	10	210	$6,940	$2.1M
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.	10	480	4,510	$90	$1.8M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	6	20	480	$730	$1.6M
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.	19	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.	20	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…	37	140	1,130	$90	$1.1M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	44	50	220	$30	$675.9K

Showing 1–10 of 673

Related Providers

Other providers that share a Tax Identification Number (TIN) with Summa Health System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Elizabeth Emley	OH	Psychologist	$3.4K	$0

Nearby Providers

Other providers in the same ZIP code as Summa Health System, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Medicine Physicians Of Cuyahoga County, Ltd	OH	Emergency Medicine Physician	$0	$19.8M
Child Guidance & Family Solutions	OH	Adolescent and Children Mental Health Clinic/Center	$0	$14.6M
Joshua Weaver	OH	Dermatopathology (Pathology) Physician	$292.8K	$106.1K
James Van Hulle	OH	Ophthalmology Physician	$279.6K	$0
Ozlem Bilgen	OH	Emergency Medicine Physician	$153.3K	$24.9K
David Drevna	OH	Urology Physician	$150.3K	$0
Tyler Taigen	OH	Clinical Cardiac Electrophysiology Physician	$126K	$0
Jason Smith	OH	Clinical Cardiac Electrophysiology Physician	$110.6K	$0
Tom Stamatis	OH	Diagnostic Radiology Physician	$101.2K	$0
Jonathan Kanam	OH	Internal Medicine Physician	$99.5K	$1.7K

Summa Health System — 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