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.

Alegent Creighton Clinic (NPI 1548287907)

Key Findings

Field	Value
Entity Type	Organization
Organization	Alegent Creighton Clinic
Address	7500 Mercy Rd
City	Omaha
State	NE
ZIP	68124
Taxonomy	Family Medicine Physician
NPI Enumerated	July 15, 2006

Payer Source	Total Paid
Medicaid	$43.2M
Medicare	$0

This provider has no Medicare billing on file and reports $43.2M in lifetime Medicaid revenue, making its public payment footprint effectively single‑payer (Medicaid) in scale. The absence of Medicare activity indicates that any payer‑strategy or network negotiations should be evaluated principally through a Medicaid lens rather than a dual‑payer mix approach.

Medicaid revenue is highly concentrated: the precomputed top three codes account for 66.2% of the provider’s Medicaid revenue, led by 99213 ($13.8M, 35.2%), followed by 99214 ($9.5M, 24.2%) and 99233 ($2.6M, 6.7%). This concentration signals that routine established outpatient E/M and inpatient subsequent care are the primary revenue drivers and that changes to utilization or reimbursement for these codes would materially affect revenues.

The code mix (dominance of 99213 and 99214) points to a high‑volume primary care practice with heavy ambulatory visit throughput and a large established patient panel; simultaneous strength in 99233 suggests the organization also delivers substantial inpatient follow‑up or hospital‑based continuity care. Together these patterns are consistent with a practice model that spans clinic‑based primary care and inpatient services rather than a narrowly focused specialty clinic.

On competitive standing, the provider ranks as a statewide leader for multiple high‑revenue codes: 99213 and 99214 each rank #1 in‑state and are labeled “extreme outlier, far above typical state volume,” and 99233 also ranks #1 (100th percentile, extreme outlier). These top rankings indicate the provider is a dominant in‑state player for core E/M services rather than a modest participant.

Beyond office visits, the provider shows meaningful emergency and acute care activity: 99284 ($1.5M, 3.8%) and 99283 ($1.4M, 3.6%) reflect emergency department visits at unremarkable to typical state volumes, while 99223 ($560.9K, 1.4%) and 99291 ($274.5K, 0.7%) both rank #1 in‑state, highlighting substantial capacity for high‑acuity inpatient and critical care services. This mix implies operational breadth across outpatient, ED, and inpatient settings.

The practice also generates sizable ancillary and preventive service volume that supports a full‑service outpatient platform: high counts and notable state standings appear for 36415 (106.5K claims, $426.1K), 93010 (67.2K claims, $873.6K), and vaccine code 90686 (26.8K claims, $375.5K). Strong state rankings for obstetric ultrasound codes (76816 $778.3K and 76805 $343.9K, both rank #1) indicate a pronounced prenatal imaging component to their Medicaid business.

Many individual codes are flagged as “extreme outlier” or “notably above typical” and sit in the 90–100th state percentiles (multiple #1 ranks across E/M, inpatient, and prenatal imaging codes). This consistent pattern of outlier volume across distinct service lines suggests system‑level scale within Nebraska—not episodic spikes—so analysts should treat these volumes as structural market share rather than isolated occurrences.

The provider’s NPI was enumerated on 2006-07-15 (~20 years ago), indicating a long operational tenure in the market. That longevity, combined with repeated high‑percentile rankings across clinical and ancillary codes, supports the view that the provider’s large Medicaid volumes reflect sustained capacity and entrenched referral or patient‑panel relationships rather than short‑term variability.

Medicaid: Complete Services Breakdown

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

211 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	292,810	$50	$13.8M
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…	150,300	$60	$9.5M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	55,900	$50	$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.	18,100	$80	$1.5M
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.	21,720	$70	$1.4M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	34,150	$30	$990.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	67,200	$10	$873.6K
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…	9,940	$90	$844.6K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	17,490	$50	$822.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	10,240	$80	$778.3K

Showing 1–10 of 211

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

Alegent Creighton Clinic — 15 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

211 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.	15	110	770	$110	$774.3K
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.	10	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.	27	80	300	$120	$519.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	18	20	240	$900	$448.5K
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…	4	40	350	$170	$366.6K
J0585	Injection, onabotulinumtoxina, 1 unit	2	10	630	$380	$355.1K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	7	10	210	$90	$329.3K
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	3	10	100	$500	$318.6K
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…	1	700	660	$70	$305.1K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	3	10	80	$630	$290.8K

Showing 1–10 of 211

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alegent Health Bergan Mercy Health System	NE	General Acute Care Hospital	$0	$45.8M
Oneworld Community Health Centers, Inc.	NE	Federally Qualified Health Center (FQHC)	$0	$45.1M
Alegent Creighton Health	NE	Internal Medicine Physician	$0	$17.5M
Alegent Creighton Clinic	IA	Family Medicine Physician	$0	$9.6M
Alegent Creighton Health	IA	Psychiatry Physician	$0	$5.8M
Alegent Creighton Health	NE	General Acute Care Hospital	$0	$4.3M
Samer Renno	NE	Hematology & Oncology Physician	$3.2M	$0
The Physician Network	NE	Family Medicine Physician	$0	$3.1M
Eric Avery	NE	Hematology & Oncology Physician	$3.1M	$0
Alegent Creighton Health	NE	General Acute Care Hospital	$0	$3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Childrens Home Healthcare	NE	Home Health Agency	$0	$40M
Maxim Healthcare Services, Inc.	NE	Home Health Agency	$0	$29.7M
Lutheran Family Services Of Ne, Inc	NE	Mental Health Counselor	$0	$5.8M
Epn Of Nebraska LLC	NE	Emergency Medicine Physician	$0	$5.6M
Ralph Hauke	NE	Hematology & Oncology Physician	$2.5M	$0
Pediatric Dental Specialists Of Greater Nebraska - Omaha, LLC	NE	Pediatric Dentistry	$0	$2.5M
Osc LLC	NE	Ambulatory Surgical Clinic/Center	$1.3M	$799.9K
Shoptikal LLC	NE	Eyewear Supplier	$0	$1.9M
Yungpo Su	NE	Hematology & Oncology Physician	$1.9M	$0
House Enterprises Inc	NE	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$1.8M

Alegent Creighton Clinic — Billing Profile & Reimbursement Data

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Alegent Creighton Clinic — 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