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.

Holzer Clinic, LLC (NPI 1508817248)

Key Findings

Field	Value
Entity Type	Organization
Organization	Holzer Clinic, LLC
Address	100 Jackson Pike
City	Gallipolis
State	OH
ZIP	45631
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicaid	$56.1M
Medicare	$0

HOLZER CLINIC, LLC is effectively a Medicaid-focused provider with $56.1M in lifetime Medicaid revenue and no Medicare billing on file; the absence of Medicare claims indicates a single-payer billing footprint in our dataset rather than a mixed Medicare/Medicaid practice. The NPI was enumerated 2006-05-15 (~20 years ago), indicating long tenure in the market.

Revenue concentration is highly skewed toward three E/M codes: 99214, 99213, and 99284 together account for 76.5% of the provider's total Medicaid revenue, underscoring that routine outpatient E/M and emergency department visits dominate the payer mix rather than high volumes of ancillary or specialty-only services. This concentration suggests that changes to E/M policy or Medicaid reimbursement for these codes would materially affect the provider’s revenue.

99214 is the single largest revenue driver with $23.4M (48.0% of Medicaid revenue) across 519.9K claims at $45 avg paid/claim; HOLZER ranks #7 of 4514 providers in-state (100th percentile; extreme outlier), which identifies the clinic as a dominant statewide provider of higher-complexity established outpatient visits. The extreme outlier status for 99214 signals very high ambulatory visit volume relative to peers and a central role in ongoing ambulatory management.

99213 is the second major driver with $8.2M (16.9% of Medicaid revenue) from 249.6K claims at $33 avg paid/claim and ranks #20 of 5077 in-state (100th percentile; extreme outlier). High volumes of both 99214 and 99213 indicate the organization operates at scale for established-patient office visits across a range of complexity, consistent with a multi-specialty ambulatory clinic model.

The presence of ED codes — notably 99284 contributing $5.6M (11.6% of Medicaid revenue) from 88.2K claims and ranking #29 of 655 (96th percentile; notably above typical state volume) — points to a significant emergency department or urgent care service line within the provider. Additional ED codes (99283, 99282, 99285) and hospital/observation code 99232 among the top billing further reinforce that acute/emergency care is an important component of operations alongside ambulatory services.

High volume for after-hours billing 99051 (89.8K claims, $1.7M revenue; ranks #3 of 151 providers in-state, 99th percentile; extreme outlier) supports that HOLZER delivers substantial care outside traditional office hours (evenings/weekends/holidays). This, combined with dominant E/M volumes, suggests extended access offerings that likely channel both routine and urgent needs to the same facility.

Procedure and imaging mix (notable entries: 20610 with 12.4K claims and $373K revenue, rank #4 of 217, 99th percentile; CT/CTA codes 74177, 74176, 71275; and diagnostic codes such as 71046 and 70450) indicates onsite procedural capabilities, advanced imaging, and diagnostic services consistent with a full-service multi-specialty clinic or hospital-affiliated outpatient center. The high rank for 20610 signals unusually large procedural throughput for joint injections relative to peers, supporting a substantive musculoskeletal service line.

Competitive standing across Medicaid: for key outpatient E/M codes HOLZER is a statewide leader (100th-percentile ranks for 99214 and 99213) and shows notably above-typical volumes in emergency care (99284 at 96th percentile). Many other technical and imaging codes sit in high percentiles (typically 90s), indicating the provider is overall a major Medicaid participant in its region rather than a modest or niche operator.

Medicaid: Complete Services Breakdown

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

406 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	519,850	$50	$23.4M
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…	249,550	$30	$8.2M
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.	88,200	$60	$5.6M
99051	The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday.	89,750	$20	$1.7M
99204	The provider sees a new 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 provider…	18,760	$70	$1.2M
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.	23,030	$40	$898.2K
99203	The provider sees a new 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 provider…	18,610	$40	$725.7K
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.	12,580	$50	$603.7K
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…	11,030	$50	$518.3K
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.	15,940	$30	$494.1K

Showing 1–10 of 406

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

Holzer Clinic, LLC — 11 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

406 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	127	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.	29	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.	214	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…	63	140	1,130	$90	$1.1M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	62	80	910	$110	$884.9K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	33	50	310	$110	$817.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	21	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	38	60	250	$730	$707.7K
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…	11	50	220	$30	$675.9K
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.	23	290	1,380	$90	$635.2K

Showing 1–10 of 406

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jonathan Hess	OH	Family Medicine Physician	$272.3K	$0
Sean Stiltner	OH	Family Medicine Physician	$243.3K	$0
Steven Conley	OH	Diagnostic Radiology Physician	$235.6K	$0
Dean Siciliano	OH	Diagnostic Radiology Physician	$229.1K	$0
Raul Gagucas	OH	Anatomic Pathology & Clinical Pathology Physician	$193.2K	$70
Rajesh Rajan	OH	Nephrology Physician	$150.4K	$0
Choudhary Rayani	OH	Clinical Cardiac Electrophysiology Physician	$141.6K	$0
Louis Gerena	OH	Sports Medicine (Family Medicine) Physician	$119.1K	$0
Glen Imlay	OH	Physical Medicine & Rehabilitation Physician	$116.2K	$0
Staci Smith	OH	Nephrology Physician	$109K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Holzer Hospital Foundation	OH	Rural Acute Care Hospital	$0	$121.3M
Gallia County Commissioners	OH	Public Health or Welfare Agency	$135.7K	$1.8M
Gallia County Commissioners	OH	Ambulance	$335.5K	$955.2K
Divya Arora	OH	Radiation Oncology Physician	$150.7K	$0
Beenu Singh	OH	Nephrology Physician	$139.3K	$0
Santpal Mavi	OH	Pulmonary Disease Physician	$99.8K	$0
Lisa Obert	OH	Vascular & Interventional Radiology Physician	$79.6K	$0
Julio Galindo	OH	Internal Medicine Physician	$67K	$0
Lori Russell	OH	Certified Registered Nurse Anesthetist	$46.2K	$0
Glenn Fisher	OH	Family Medicine Physician	$32.7K	$0

Holzer Clinic, LLC — 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