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.

University Hospitals Cleveland Medical Center (NPI 1518042175)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Hospitals Cleveland Medical Center
Address	11100 Euclid Ave
City	Cleveland
State	OH
ZIP	44106
Taxonomy	Children's Hospital
NPI Enumerated	October 25, 2006

Payer Source	Total Paid
Medicaid	$76.7M
Medicare	$0

This provider has no Medicare billing on file and is effectively a single-payer (Medicaid) facility in our dataset, with total Medicaid revenue of $76.7M reported. The absence of Medicare activity means analyses of older-adult care or fee-for-service Medicare mix are not applicable for this profile and Medicaid drives the provider’s revenue footprint.

Revenue concentration is notable: the precomputed top-three Medicaid codes account for 34.3% of the provider’s total Medicaid revenue, indicating a material dependence on a small set of services for roughly one-third of collections. That concentration suggests operational focus and financial sensitivity to changes in reimbursement or utilization for those high-contribution codes.

Emergency department and outpatient E/M services are major components of the billing mix: 99283 ($10.7M, 16.1% of Medicaid revenue) is the single largest Medicaid revenue code, and several other ED E/M codes (99282, 99284, 99285, 99281) also appear in the top-25 list. This pattern indicates the hospital operates a high-volume ED and emergency/acute outpatient workflow underpinning Medicaid volume.

Dental, oral surgery, and related pediatric procedures also drive sizable Medicaid revenue — codes such as 41899 ($6.6M, 9.9%), D2930 ($5.2M, 7.8%), D7140, D1351, D2330 and D2391 collectively reflect substantial dental service lines. The provider’s top-25 mix suggests a strong pediatric dental and surgical program integrated with its broader children’s hospital services.

Behavioral/developmental screening and preventive pediatrics are prominent: 96127 ($3.7M, 5.5%), 96110 ($1.9M, 2.8%), and preventive well visits 99391/99392/99393/99394 together represent a meaningful share of claims and revenue. High volumes of these codes point to a systematic emphasis on developmental screening and routine pediatric preventive care within the Medicaid population.

Competitive standing within Ohio varies by code: the provider ranks #1 of 30 for 41899 and is labeled an "extreme outlier, far above typical state volume" for that code, indicating a unique statewide leadership position in that specific dental procedure. For many high-volume E/M and pediatric screening codes (e.g., 99283 at the 92th percentile, 99214 at the 97th percentile, 96127 at the 99th percentile) the provider sits well above typical state volumes, demonstrating dominant or above-typical market participation in multiple pediatric-focused services.

Although many individual codes show high percentiles, some high-complexity ED services are more typical in-state (for example, 99285 ranks at the 67th percentile), suggesting the provider’s strongest differentiation is in mid-to-low complexity ED visits, dental procedures, and pediatric prevention/screening rather than uniformly across all high-acuity emergency care. This nuance can inform competitive benchmarking and network contracting priorities.

The provider’s NPI was enumerated approximately 20 years ago (2006-10-25), indicating long tenure in the market. This extended presence combined with concentrated Medicaid revenue and leadership in select pediatric/dental codes suggests established clinical programs and referral relationships sustaining its Medicaid business.

Medicaid: Complete Services Breakdown

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

328 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.	68,860	$160	$10.7M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	6,610	$1,000	$6.6M
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…	36,940	$150	$5.5M
D2930	N/A	9,950	$520	$5.2M
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…	35,960	$140	$5M
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	28,150	$130	$3.7M
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.	24,890	$150	$3.6M
99391	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…	28,810	$120	$3.5M
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.	15,720	$170	$2.7M
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…	20,310	$120	$2.4M

Showing 1–10 of 328

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

University Hospitals Cleveland Medical Center — 12 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

328 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	120	150	4,030	$100	$5.9M
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.	127	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.	38	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.	147	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.	195	580	510	$100	$1.3M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	9	20	260	$1,470	$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.	1	30	520	$820	$994.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	11	80	100	$860	$719.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	40	100	$850	$680.6K
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.	189	290	1,380	$90	$635.2K

Showing 1–10 of 328

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Hospitals Cleveland Medical Center	OH	General Acute Care Hospital	$0	$156.9M
University Hospitals St. John Medical Center	OH	General Acute Care Hospital	$0	$11.8M
David Smullen	WI	Diagnostic Radiology Physician	$75.5K	$0
Patricia Rudler	OH	Acute Care Nurse Practitioner	$74.6K	$0
Jennifer Root	OH	Acute Care Nurse Practitioner	$36.4K	$5.1K
Paula Ogrocki	OH	Clinical Neuropsychologist	$12K	$0
Jennifer Legros	OH	Adult Health Nurse Practitioner	$10.8K	$0
Jiayi Tao	OH	Physician Assistant	$6.1K	$0
Jacquelyn Mccloskey	OH	Physician Assistant	$4.3K	$0
Mario Manacci	OH	Acute Care Nurse Practitioner	$4.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Hospitals Medical Group Inc	OH	Multi-Specialty Clinic/Center	$0	$107.5M
University Hospitals Laboratory Services Foundation	OH	Clinical Medical Laboratory	$8.4M	$41.1M
Circle Health Services	OH	Federally Qualified Health Center (FQHC)	$0	$7.1M
Community Dialysis Center	OH	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7M
Adir Ludin	OH	Radiation Oncology Physician	$1.6M	$0
Katarzyna Brodowska	OH	Ophthalmology Physician	$929.6K	$162.9K
Eric Palfreyman	OH	Internal Medicine Physician	$1M	$0
Shree Kurup	OH	Ophthalmology Physician	$533.2K	$0
Roy Raad	OH	Diagnostic Radiology Physician	$459.2K	$46.8K
Ari Konheim	OH	Dermatology Physician	$441K	$0

University Hospitals Cleveland Medical Center — Billing Profile & Reimbursement Data

Sign up for University Hospitals Cleveland Medical Center — Billing Profile & Reimbursement Data policy alerts

University Hospitals Cleveland Medical Center — Billing Profile & Reimbursement Data

Sign up for University Hospitals Cleveland Medical Center — Billing Profile & Reimbursement Data policy alerts

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