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

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

West Allis Memorial Hospital, Inc. (NPI 1407801640)

Key Findings

Field	Value
Entity Type	Organization
Organization	West Allis Memorial Hospital, Inc.
Address	8901 W Lincoln Ave
City	West Allis
State	WI
ZIP	53227
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$23.3M
Medicare	$0

WEST ALLIS MEMORIAL HOSPITAL, INC. appears effectively single-payer in the available dataset: there is no Medicare billing on file while total Medicaid revenue is $23.3M, so all reported federal program revenue for this profile is driven by Medicaid. This concentration means payer-specific analyses should treat Medicaid as the primary commercial influence on revenue and utilization in this dataset.

Revenue concentration is high at the code level: the precomputed top three Medicaid codes — 96361, 99284, and 99283 — account for 39.9% of this provider's total Medicaid revenue. Those three codes (96361 reported as $2.3M, 99284 reported as $2.1M, and 99283 reported as $2.1M) indicate the bulk of Medicaid dollars are concentrated in infusion/IV fluid services and emergency department E/M visits.

The code mix points to a hospital with heavy emergency department throughput and concurrent infusion/acute care services: 99284 (36.9K claims, $2.1M revenue), 99283 (35.7K claims, $2.1M revenue) and 99285 (21.2K claims, $1.3M revenue) dominate E/M volume, while infusion-related codes such as 96361 (17.3K claims, $2.3M revenue), 96360 (5.9K claims, $556.7K revenue) and 96365 (5.3K claims, $373.5K revenue) add material revenue. Imaging and lab procedures (74177, 70450, 80053) and substantial therapy lines (97110, 97112, 97140) show a full-service acute care operating footprint rather than a narrowly specialized clinic.

On statewide competitive standing for ED services this provider ranks consistently in the upper percentiles: 99284 ranks #17 of 432 providers (96th percentile), 99283 ranks #18 of 362 (95th percentile), and 99285 ranks #21 of 331 (94th percentile). Those placements indicate a major emergency department presence within Wisconsin, with utilization and revenue for ED E/M codes well above typical peer volumes statewide.

Infusion, laboratory, and imaging volumes are generally above typical state levels but not extreme outliers: 96361 ranks #12 of 135 (92th percentile), 96360 ranks #12 of 110 (90th percentile), 80053 ranks #26 of 261 (90th percentile), and 80047 ranks #3 of 35 (94th percentile). This profile suggests robust throughput in IV/infusion treatments and diagnostic testing that supports the ED and inpatient workflows.

There are a couple of notable service-line outliers where the provider is especially prominent: 74176 (CT abdomen/pelvis without contrast) ranks #5 of 161 (98th percentile; notably above typical state volume), and 58661 (laparoscopic oophorectomy/tubal procedures) ranks #1 of 8 (100th percentile; notably above typical state volume). These rankings highlight areas—imaging for abdominal/pelvic complaints and selected gynecologic surgery—where the hospital’s case mix or referral patterns differ markedly from most peers.

Outpatient rehabilitation is a measurable revenue contributor and a comparative strength: 97110 (27.5K claims, $796.8K revenue) ranks #27 of 631 providers (96th percentile; notably above typical state volume), 97112 (13.6K claims, $448.5K revenue) ranks #10 of 221 (96th percentile), and 97140 (15.9K claims, $350K revenue) ranks #17 of 238 (93th percentile). These placements signal a sustained volume of therapeutic exercise, neuromuscular reeducation, and manual therapy consistent with an integrated PT/rehab program at the hospital.

The provider has an established enrollment history with NPI enumerated on 2006-05-24 (~20 years ago), indicating long tenure in the market. Combined with the Medicaid-only billing footprint in this dataset, this tenure suggests operational stability focused on the local Medicaid population and acute-care service lines rather than relying on Medicare revenue in the reported period.

Medicaid: Complete Services Breakdown

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

329 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	17,320	$130	$2.3M
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.	36,900	$60	$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.	35,670	$60	$2.1M
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.	21,150	$60	$1.3M
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…	27,480	$30	$796.8K
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.	10,840	$70	$704.5K
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.	8,030	$80	$642.4K
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.	8,790	$70	$623.9K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	5,860	$100	$556.7K
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.	33,990	$20	$509.8K

Showing 1–10 of 329

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

West Allis Memorial Hospital, Inc. — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

329 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.	12	140	3,200	$160	$1.1M
P9016	Red blood cells, leukocytes reduced, each unit	10	10	750	$590	$906.4K
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.	18	360	1,550	$70	$614.4K
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.	17	430	760	$60	$484.6K
J0585	Injection, onabotulinumtoxina, 1 unit	19	30	550	$240	$428.8K
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.	17	190	1,790	$90	$390.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	27	140	2,200	$90	$358.4K
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.	21	330	1,350	$60	$338K
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…	33	170	720	$70	$272.7K
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.	26	260	3,590	$20	$232.2K

Showing 1–10 of 329

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aurora Medical Group, Inc.	WI	Certified Registered Nurse Anesthetist	$2.2K	$139.2M
Lakeshore Medical Clinic, LLC	WI	Family Medicine Physician	$0	$8.4M
Jeffrey Bahr	WI	Internal Medicine Physician	$3.1M	$356.4K
Aurora Medical Group, Inc.	WI	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.2M
Steven Port	WI	Cardiovascular Disease Physician	$506.2K	$0
Christopher Kolibash	WV	Clinical Cardiac Electrophysiology Physician	$425.8K	$48K
Prakash Shah	WI	Cardiovascular Disease Physician	$341K	$15.1K
Ijaz Malik	WI	Cardiovascular Disease Physician	$213K	$0
Vikram Nangia	WI	Clinical Cardiac Electrophysiology Physician	$211.8K	$0
Anthony De Franco	WI	Cardiovascular Disease Physician	$210.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A2cl Services, LLC	WI	Clinical Medical Laboratory	$19M	$98.7M
Visiting Nurse Association Of Wisconsin, Inc.	WI	Home Infusion Therapy Pharmacy	$0	$21.3M
Visiting Nurse Association Of Wisconsin, Inc.	WI	Home Health Agency	$0	$15.4M
Premier Care Of Wisconsin, LLC.	WI	Methadone Clinic	$204.8K	$11.2M
Great Lakes Pathologists Sc	WI	Anatomic Pathology & Clinical Pathology Physician	$0	$6.4M
Samer Dola	WI	Hematology (Pathology) Physician	$103.3K	$5.8M
Planned Parenthood Of Wisconsin	WI	Ambulatory Family Planning Facility	$0	$5.2M
Atlas Healthcare, Inc	WI	Home Health Agency	$0	$4.5M
Surgicenter Of Greater Milwaukee, LLC	WI	Ambulatory Surgical Clinic/Center	$0	$4.4M
West Allis School District	WI	Local Education Agency (LEA)	$0	$4.3M

West Allis Memorial 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