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.

Mercy Health Youngstown LLC (NPI 1548296106)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mercy Health Youngstown LLC
Address	1044 Belmont Ave
City	Youngstown
State	OH
ZIP	44504
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 24, 2006

Payer Source	Total Paid
Medicaid	$63.7M
Medicare	$0

This provider is effectively a single-payer Medicaid hospital in the available data: there is no Medicare billing on file while Total Medicaid revenue is $63.7M, indicating Medicaid dominates the observable payer mix for MERCY HEALTH YOUNGSTOWN LLC. Analysts should treat Medicare-related comparisons as not applicable for this entity given the absence of Medicare claims.

Medicaid revenue is concentrated in emergency and outpatient evaluation & management services: the top three Medicaid codes (99283, 99284, G0463) together account for 46.8% of the provider's total Medicaid revenue, signaling that a large share of income derives from ED visits and hospital outpatient clinic assessments rather than elective inpatient procedures. This concentration implies operational emphasis on emergency care throughput and outpatient diagnostics.

Emergency department acuity mix is weighted toward moderate-to-high complexity: high-volume ED codes 99283 ($9.3M, ranks #31 of 484, 94th percentile), 99284 ($8.8M, ranks #35 of 655, 95th percentile) and 99285 ($6M, ranks #42 of 581, 93th percentile) together represent a substantial portion of Medicaid revenue, which is consistent with a busy ED handling a range of low- to high-complexity presentations compared with in-state peers. These rank-percentiles indicate above-typical state volume for these ED services.

Imaging and diagnostics are prominent revenue drivers alongside ED activity: CT head 70450 ($5M, ranks #19 of 286, 94th percentile) and CT abdomen/pelvis 74177 ($2.9M, ranks #25 of 280, 91th percentile) are among the top Medicaid codes, and high-volume lab panels (80053, 85025, 80061) and TSH testing (84443) also contribute meaningfully. This code mix suggests substantial onsite radiology and laboratory capacity supporting emergency and outpatient care.

Competitive standing in-state is strong for several high-use codes: the provider ranks in the top decile or better for multiple high-revenue codes (for example 99283 at the 94th percentile, 99284 at the 95th percentile, G0463 at the 89th percentile, and 80053 at the 97th percentile), indicating it is a major regional provider for ED visits and certain outpatient services relative to peers. However, many mid- and lower-revenue codes show typical or unremarkable volume, so dominance is concentrated in specific service lines.

Operational implications from revenue mix point to resource allocation priorities: with nearly half of Medicaid revenue concentrated in three codes and substantial revenue from imaging and lab services, the hospital likely requires continued investment in emergency department staffing, CT imaging capacity, and high-throughput laboratories to support its payer mix and revenue streams. Payers negotiating contracts should expect utilization driven by emergency care and outpatient diagnostics.

The provider has long tenure in public enrollment, with NPI enumerated on 2006-06-24 (~20 years ago), which supports interpretation of these utilization patterns as established rather than new-market behavior. Historical presence may also explain the high percentile ranks in-state for core ED and outpatient services.

Medicaid: Complete Services Breakdown

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

512 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.	81,710	$110	$9.3M
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.	72,560	$120	$8.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	81,940	$80	$6.6M
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.	44,230	$140	$6M
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.	20,280	$250	$5M
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.	11,550	$250	$2.9M
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.	5,680	$320	$1.8M
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.	20,120	$90	$1.8M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	142,770	$10	$1.7M
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	3,500	$270	$930.5K

Showing 1–10 of 512

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

Mercy Health Youngstown LLC — 2 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

512 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	17	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.	75	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.	31	480	4,510	$90	$1.8M
H2020	Therapeutic behavioral services, per diem	149	310	1,190	$150	$1.5M
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.	35	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.	42	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…	26	140	1,130	$90	$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.	26	30	520	$820	$994.5K
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…	23	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.	19	290	1,380	$90	$635.2K

Showing 1–10 of 512

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Physicians Youngstown, LLC	OH	Family Medicine Physician	$0	$25.1M
Mercy Health Physicians Youngstown Specialty Care LLC	OH	Surgery Physician	$0	$11.8M
Focuscare LLC	OH	Addiction (Substance Use Disorder) Counselor	$0	$8.5M
Mahoning Valley Emergency Specialists LLC	OH	Emergency Medicine Physician	$0	$7.7M
Dwight Heron	OH	Radiation Oncology Physician	$227.3K	$0
Albert Cook	OH	Vascular & Interventional Radiology Physician	$170.3K	$0
Nathaniel Doe	OH	Nephrology Physician	$145.8K	$1.2K
David Hoffman	OH	Cardiovascular Disease Physician	$138.3K	$0
Venkata Kollipara	OH	Vascular Surgery Physician	$101.2K	$0
Chakri Yarlagadda	OH	Cardiovascular Disease Physician	$98.9K	$0

Mercy Health Youngstown LLC — Billing Profile & Reimbursement Data

Sign up for Mercy Health Youngstown LLC — Billing Profile & Reimbursement Data policy alerts

Mercy Health Youngstown LLC — Billing Profile & Reimbursement Data

Sign up for Mercy Health Youngstown LLC — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Health Youngstown LLC	OH	General Acute Care Hospital	$0	$43.6M
Mercy Health Youngstown LLC	OH	General Acute Care Hospital	$0	$36.6M
Brianne Bagwell	OH	Family Medicine Physician	$104.8K	$0
John Vargo	OH	Gastroenterology Physician	$32.2K	$0