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

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

Nebraska Methodist Hospital (NPI 1427147883)

Key Findings

Field	Value
Entity Type	Organization
Organization	Nebraska Methodist Hospital
Address	8303 Dodge Street
City	Omaha
State	NE
ZIP	68114
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 12, 2006

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

NEBRASKA METHODIST HOSPITAL reports no Medicare billing on file and $14.5M in lifetime Medicaid revenue, indicating its reported public-payer activity for the dataset is effectively single-payer Medicaid rather than a mixed Medicare/Medicaid profile. This absence of Medicare revenue suggests analysts should treat comparisons to Medicare-based peers as inapplicable for this facility and focus competitive analysis on Medicaid dynamics within Nebraska.

Revenue concentration is moderate: the precomputed top 3 Medicaid codes account for 37.5% of the provider's total Medicaid revenue, signaling that a minority set of services drive over one-third of Medicaid receipts. That concentration points to a reliance on a few high-volume or higher-paid service lines while the remaining revenue is spread across many other codes.

The top Medicaid codes reflect an ED- and imaging-heavy outpatient footprint: high-ranking codes include emergency department E/M codes 99284, 99283, and 99285 as well as CT abdomen/pelvis codes 74177 and 74176 and CT head 70450. Together, these codes imply the hospital operates a busy emergency department with substantial diagnostic imaging and IV infusion services supporting acute care and observation workflows.

Specific service-line drivers include infusion and dehydration treatment codes: 96361, 96365, 96360 and related infusion codes appear among the top revenue contributors, with 96361 yielding $1.4M (12.4% of Medicaid revenue). This pattern indicates frequent IV fluid and infusion treatments for Medicaid patients, consistent with an ED and short-stay inpatient/observation population.

Competitive standing in-state is generally solid but not dominant: several high-volume lab and imaging codes (80053 CMP, 84443 TSH, 70450 CT head) rank in the top few providers statewide, with 80053 at rank #3 of 133 (98th percentile) and 84443 at rank #4 of 84 (96th percentile), indicating notably above-typical state volume for routine lab testing. Emergency visit codes such as 99284 and 99283 are in the mid-to-high percentiles (84th–86th), which reflects typical, unremarkable statewide volumes for ED visits rather than exclusive market dominance.

There are notable above-typical volumes in obstetric ultrasound services: 76815 ranks #2 of 20 providers in-state (95th percentile) and 76816 ranks #5 of 27 (85th percentile), showing this hospital provides a comparatively high volume of prenatal ultrasound services to Medicaid patients and is a meaningful provider in maternal-fetal imaging within the state.

A few codes show exceptional state positioning: 58661 (laparoscopic removal of ovaries/fallopian tubes) reports $118.7K and ranks #1 of 1 providers in-state, meaning this entity is the only reported biller for that procedure in the state dataset; this should be treated as a data-coverage observation rather than an operational claim about exclusivity. Similarly, 80053 (CMP) and 84443 (TSH) are described as notably above typical state volume, reinforcing the hospital's role as a major outpatient lab resource for Medicaid.

Tenure is long: the provider's NPI was enumerated on 2006-10-12 (approximately 20 years ago), indicating sustained presence in the market and that observed billing patterns reflect an established facility rather than a recent entrant. Analysts can consider this longevity when interpreting competitive positioning and referral relationships in Medicaid networks.

Medicaid: Complete Services Breakdown

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

277 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	13,150	$110	$1.4M
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.	5,890	$230	$1.4M
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.	12,190	$110	$1.3M
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.	3,000	$320	$947.4K
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.	4,290	$150	$643.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	2,930	$160	$460K
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.	2,180	$200	$444.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	4,950	$80	$411K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	4,920	$80	$398.4K
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.	3,900	$100	$382.3K

Showing 1–10 of 277

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Nebraska Methodist Hospital — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

277 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	110	770	$110	$774.3K
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.	5	40	820	$260	$734.1K
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.	20	140	1,100	$110	$607.4K
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.	16	80	300	$120	$519.5K
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.	11	50	820	$160	$461.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	33	40	350	$170	$366.6K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	11	20	270	$260	$342.4K
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…	171	700	660	$70	$305.1K
G0378	Hospital observation service, per hour	6	30	950	$120	$276.4K
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.	12	50	830	$90	$269K

Showing 1–10 of 277

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nebraska Methodist Hospital	NE	Emergency Medicine Physician	$0	$5.3M
Thomas Franco	NE	Physical Medicine & Rehabilitation Physician	$526.6K	$0
John Henry	NE	Cardiovascular Disease Physician	$355.7K	$0
Mark Chouinard	NE	Cardiovascular Disease Physician	$323K	$0
Edmund Fiksinski	NE	Interventional Cardiology Physician	$293.9K	$0
Thomas Hejkal	NE	Ophthalmology Physician	$264.5K	$0
William Nester	NE	Interventional Cardiology Physician	$255.8K	$0
Jeffrey Mahoney	NE	Clinical Cardiac Electrophysiology Physician	$254.4K	$0
Herbert Hartman	NE	Cardiovascular Disease Physician	$249.4K	$0
Michael Giitter	NE	Internal Medicine Physician	$225.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital & Medical Center	NE	Children's Hospital	$0	$89.8M
Children's Physicians	NE	Pediatrics Physician	$0	$39.4M
Nebraska Pediatric Practice, Inc	NE	Pediatrics Physician	$0	$29M
Physicians Clinic Inc	NE	Family Medicine Physician	$0	$20.5M
Smiles 4 Kids PC	NE	General Practice Dentistry	$0	$11.5M
Children's Hospital	NE	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$8.4M
Unmc College Of Dentistry	NE	Dentist	$0	$4.8M
Stones Worth Stepping, P.C.	NE	Occupational Therapist	$0	$4.7M
Pacific Surgery Center, LLC	NE	Ambulatory Surgical Clinic/Center	$3.4M	$3.2K
Stefano Tarantolo	NE	Hematology & Oncology Physician	$3.2M	$0

Nebraska Methodist 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