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.

Sharp Memorial Hospital (NPI 1407839921)

Field	Value
Entity Type	Organization
Organization	Sharp Memorial Hospital
Address	7901 Frost St
City	San Diego
State	CA
ZIP	92123
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 29, 2005

Payer Source	Total Paid
Medicaid	$133.7M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric public-program facility in the available data: there is no Medicare billing on file while Total Medicaid revenue is $133.7M, so payer-comparison analysis must focus on Medicaid activity rather than a mixed Medicare/Medicaid case mix. The absence of Medicare billing limits national Medicare peer comparisons for this NPI.

Revenue is highly concentrated in a small set of procedures: the top three Medicaid codes (99283, 0450, 74177) account for 50.1% of the provider's total Medicaid revenue, with 99283 generating $23.1M (21.0%), 0450 generating $21.1M (19.2%), and 74177 generating $10.9M (10.0%). This concentration signals the provider’s financial exposure is tied closely to a few high-volume ED and imaging services.

The code mix points to a strong emergency-department and diagnostic-imaging operating model: high-volume ED E/M codes such as 99283 (46.4K claims) and additional ED codes 99284 and 99285 appear among top-revenue items, while advanced CT imaging codes such as 74177 (15K claims) and related chest/abdomen CT codes are sizable revenue contributors. Together these patterns are consistent with a hospital that receives substantial ED throughput and relies on CT imaging to drive downstream revenue.

Competitive standing by code shows the provider is a major in-state participant for several ED and imaging services: 99283 ranks #108 of 1570 in-state (93th percentile; notably above typical state volume) and 74177 ranks #55 of 783 (93th percentile), indicating above-average volume for these revenue drivers. By contrast, 0450 ranks #109 of 450 (76th percentile; typical, unremarkable volume), so not all top-line codes reflect dominant share.

Several specific service lines show statistically elevated use relative to in-state peers: 99499 ranks #8 of 307 (98th percentile; notably above typical state volume) and 93005 ranks #21 of 760 (97th percentile; notably above typical state volume), while procedural infusions and injections (96374, 96375) and spinal CT (72125) also list as notably above typical state volume. These outlier labels suggest higher-than-typical deployment of unlisted E/M, ECG monitoring, IV medication/infusion services, and selected advanced imaging at this site.

High-volume laboratory and monitoring throughput supports the acute-care profile: 80053 (117.6K claims, $4.8M; 4.4%) and 85025 (120.2K claims, $2.2M; 2.0%) are large-claim contributors and 84484 (32.4K claims, $875.2K; 0.8%) further supports frequent cardiac evaluation. The lab claim counts and revenues are consistent with continuous ED/inpatient throughput and routine monitoring tied to emergency and inpatient episodes.

The provider has long-standing participation in billing systems, with NPI enumeration dated 2005-11-29 (~21 years ago), indicating an established operational history in the market; the longevity combined with concentrated Medicaid revenue suggests an entrenched local role in serving public-pay patients. This tenure strengthens the case for focusing competitive analysis on in-state Medicaid positioning and operational capacity.

Analysts should prioritize in-state Medicaid peer comparisons and operational metrics (ED visit volumes, CT capacity, lab throughput, and infusion/IV services) because Medicare comparisons are not possible for this NPI. Given the top-3 concentration (50.1%) and multiple codes flagged as "notably above typical state volume," investigations into capacity, throughput drivers, and reimbursement sensitivity around ED and imaging lines will be most material for payer or network decisions.

Medicaid: Complete Services Breakdown

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

306 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.	46,360	$500	$23.1M
0450	N/A	63,030	$340	$21.1M
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.	15,020	$730	$10.9M
99499	Use 99499 to report evaluation and management services for which there is no specific code available.	22,200	$330	$7.3M
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.	117,650	$40	$4.8M
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.	17,390	$250	$4.4M
99199	Use this code to report other medicine services or procedures for which there is no specific code available.	5,180	$820	$4.2M
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.	8,490	$420	$3.6M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	53,160	$60	$3.1M
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.	11,200	$270	$3.1M

Showing 1–10 of 306

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

Sharp Memorial Hospital — 10 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

306 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
0450	N/A	109	450	16,140	$90	$3.6M
0206	N/A	34	40	80	$2,760	$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.	108	1,570	680	$110	$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.	261	1,300	510	$100	$943K
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…	137	750	950	$50	$890K
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.	277	1,400	470	$80	$884.5K
99281	The provider sees a patient for the lowest level emergency department visit.	310	430	1,140	$90	$769.9K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	150	230	270	$840	$717.2K
G0378	Hospital observation service, per hour	94	200	550	$310	$605.9K
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.	55	780	1,160	$130	$576.2K

Showing 1–10 of 306

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sharp Healthcare	CA	Clinical Medical Laboratory	$498.4K	$970
Sharp Healthcare	CA	Clinical Medical Laboratory	$440.3K	$530
Sharp Healthcare	CA	Clinical Medical Laboratory	$258.3K	$60
Sharp Healthcare	CA	Clinical Medical Laboratory	$80.8K	$950
Enrique Moreno Martinez	CA	Vascular Surgery Physician	$73.6K	$0
Michelle Dao	CA	Physician Assistant	$12.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kaiser Foundation Hospitals	CA	General Acute Care Hospital	$0	$93.1M
Rady Children's Hospital San Diego	CA	Pediatrics Physician	$0	$77.3M
American Medical Response Ambulance Service Inc	CA	Ambulance	$9.6M	$65.4M
Rady Children's Hospital San Diego	CA	Children's Hospital	$0	$69.1M
Serene Health	CA	Mental Health Counselor	$0	$60.5M
Rac & Associates, Inc.	CA	Durable Medical Equipment & Medical Supplies	$0	$58.2M
Anesthesia Service Medical Group	CA	Anesthesiology Physician	$0	$31M
Balboa Nephrology Medical Group, Inc.	CA	Nephrology Physician	$0	$25.9M
Centro De Salud De La Comunidad De San Ysidro, Inc.	CA	Dental Clinic/Center	$0	$22.3M
Atul Jain	CA	Ophthalmology Physician	$3.5M	$0

Sharp Memorial Hospital — 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