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

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

Paintsville Hospital Company, LLC (NPI 1538101688)

Field	Value
Entity Type	Organization
Organization	Paintsville Hospital Company, LLC
Address	625 James Trimble Blvd
City	Paintsville
State	KY
ZIP	41240
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

232 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.	20,920	$130	$2.6M
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.	10,760	$200	$2.2M
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.	7,500	$290	$2.2M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,610	$210	$1.4M
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.	5,270	$100	$510.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,670	$190	$316.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	4,490	$60	$273.7K
G0378	Hospital observation service, per hour	2,960	$80	$239.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5,670	$40	$238K
71250	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material.	2,660	$80	$220.9K

Showing 1–10 of 232

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Paintsville Hospital Company, LLC — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

232 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.	112	280	7,150	$150	$3M
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.	94	240	4,710	$150	$2.6M
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…	40	70	1,650	$100	$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.	68	280	5,700	$120	$2M
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.	132	180	1,870	$280	$1.5M
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…	41	50	2,830	$90	$1.4M
G0378	Hospital observation service, per hour	41	90	2,770	$190	$1.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	43	80	7,740	$30	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	30	170	2,610	$250	$1M
G0481	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	990	$60	$912.2K

Showing 1–10 of 232

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arh Tug Valley Health Services, Inc.	KY	General Acute Care Hospital	$0	$33.8M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Highlands Hospital Corp	KY	Cardiovascular Disease Physician	$0	$15.9M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Arh Tug Valley Health Services, Inc.	KY	General Acute Care Hospital	$0	$10.4M
Jason Fogg	KY	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$1.2M	$0
Bahram Forouzandeh	KY	Gastroenterology Physician	$59K	$925.9K
Randall Mann	KY	Optometrist	$38K	$542.8K
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0

Nearby Providers

Other providers in the same ZIP code as Paintsville Hospital Company, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Comprehensive Care Center, Inc.	KY	Federally Qualified Health Center (FQHC)	$0	$12.8M
New Age Vitality Clinic LLC	KY	Family Medicine Physician	$0	$10M
Paintsville Behavioral Health, Inc	KY	Psychiatric/Mental Health Registered Nurse	$0	$7.7M
Bhg Xxiv, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$174.7K	$7.4M
Kimberly Nordin	KY	Optometrist	$27.3K	$3.2M
City Of Paintsville Office Of Treasurer	KY	Land Ambulance	$324.3K	$1.5M
Rick O'bryan	KY	Physical Therapist	$101.4K	$0
Kevin Bayes	KY	Family Medicine Physician	$77.9K	$0
Robert Miller	KY	Podiatrist	$27.2K	$23.3K

Paintsville Hospital Company, LLC — Billing Profile & Reimbursement Data

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Paintsville Hospital Company, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References