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.

The Toledo Hospital (NPI 1407854771)

Field	Value
Entity Type	Organization
Organization	The Toledo Hospital
Address	2142 N Cove Blvd
City	Toledo
State	OH
ZIP	43606
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$151.2M
Medicare	$0

Payer mix and scale: THE TOLEDO HOSPITAL appears to operate effectively as a Medicaid-focused provider — there is no Medicare billing on file while total Medicaid revenue is $151.2M. This makes the provider essentially single‑payer (Medicaid) in the dataset rather than a mixed Medicare/Medicaid hospital profile, which is important for contracting and utilization benchmarking.

Medicaid: Complete Services Breakdown

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

777 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.	133,430	$110	$14.9M
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.	93,780	$140	$12.7M
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.	33,720	$270	$9M
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…	119,570	$70	$8.6M
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…	30,900	$170	$5.1M
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.	29,130	$170	$4.8M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	46,590	$80	$3.6M
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	42,370	$70	$3M
81514	The lab analyst performs the technical lab tests on a vaginal fluid specimen for quantitative real–time amplification of DNA markers for six bacterial species listed in the code descriptor, and…	17,800	$150	$2.7M
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.	10,630	$240	$2.5M

Showing 1–10 of 777

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

The Toledo Hospital — 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

777 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	39	150	4,030	$100	$5.9M
J9271	Injection, pembrolizumab, 1 mg	20	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.	8	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.	16	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.	25	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.	65	580	510	$100	$1.3M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	15	20	260	$1,470	$1.1M
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…	11	140	1,130	$90	$1.1M
90999	Use 90999 to report dialysis services or procedures that do not have a specific code.	264	270	8,860	$80	$1.1M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	25	30	520	$820	$994.5K

Showing 1–10 of 777

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Timothy Kasunic	OH	Hematology & Oncology Physician	$2M	$0
Shaili Desai	OH	Hematology & Oncology Physician	$1.2M	$0
Meghan Beck	OH	Physician Assistant	$381.5K	$0
Ahed Nahhas	OH	Cardiovascular Disease Physician	$375.9K	$0
Ghiath Yazji	OH	Cardiovascular Disease Physician	$366.6K	$0
Fadhil Hussein	OH	Cardiovascular Disease Physician	$307.2K	$0
Ashok Biyani	OH	Orthopaedic Surgery of the Spine Physician	$297.9K	$0
David Ervin	OH	Sports Medicine (Orthopaedic Surgery) Physician	$257.1K	$0
Thomas Andreshak	OH	Orthopaedic Surgery Physician	$252.4K	$0
Joseph Assenmacher	OH	Orthopaedic Surgery Physician	$246.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Harbor	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$77.4M
Emergency Physicians Of Northwest Ohio Inc.	OH	Emergency Medicine Physician	$0	$32.6M
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$22.2M
Pharmacy Counter, LLC	OH	Durable Medical Equipment & Medical Supplies	$0	$19.7M
Empowered For Excellence Behavioral Health Ohio	OH	Community/Behavioral Health Agency	$0	$13.4M
Empowered For Excellence Behavioral Health Ohio	OH	Community/Behavioral Health Agency	$0	$11.1M
Harbor	OH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.4M
A Better Life 2 Embrace LLC (a.b.l.e.) LLC	OH	Community/Behavioral Health Agency	$0	$9.9M
Toledo Radiological Associates, Inc.	OH	Diagnostic Radiology Physician	$0	$9.4M
Prime Hha, LLC	OH	Home Health Agency	$0	$9.1M

The Toledo Hospital — Billing Profile & Reimbursement Data

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The Toledo 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