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

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

Potomac Hospital Corporation Of Prince William (NPI 1548366404)

Key Findings

Field	Value
Entity Type	Organization
Organization	Potomac Hospital Corporation Of Prince William
Address	2300 Opitz Blvd
City	Woodbridge
State	VA
ZIP	22191
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 16, 2006

Payer Source	Total Paid
Medicaid	$59.2M
Medicare	$0

This provider has no Medicare billing on file and reported Total Medicaid revenue of $59.2M, making its public payer footprint effectively single-payer Medicaid in the available data. The absence of Medicare activity suggests the facility’s billing and utilization patterns are concentrated in Medicaid populations and reimbursement policies.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top three codes account for 55.5% of the provider’s total Medicaid revenue, with 99283 generating $12.7M (24.9%), 99284 generating $8.4M (16.5%), and 96361 generating $7.2M (14.1%). This concentration indicates that a handful of acute-care and infusion services drive the majority of reported Medicaid receipts.

The code mix points to a high-volume emergency department and acute-care operation: 99283, 99284, 99285, and 99282 are among the top revenue drivers and collectively represent substantial ED E/M activity. 99283 in particular is large ($12.7M) and is described as notably above typical state volume, ranking #20 of 626 providers in-state (97th percentile), which supports the interpretation that this hospital handles a heavy ED case load across acuity levels.

Infusion and dehydration treatment are a clear service-line focus: 96361 ($7.2M), 96360 ($901K), 96365 ($513.1K), and 96366 ($402.9K) appear repeatedly in the top codes, indicating frequent use of IV fluids and medication infusions. These codes’ presence alongside high ED volumes suggests the facility manages significant acute medical needs that require IV therapies and observation-level care.

Imaging and obstetric services are prominent ancillary lines: CT codes such as 74177 ($2.4M) and 70450 ($2M), CTA 71275 ($906K), and a cluster of ultrasound and fetal-monitoring codes (76830 $361.6K, 76856 $350.2K, 76815 $288.1K, 59025 $783.7K) show meaningful revenue and volume. Several imaging/OB codes rank highly in-state (76856 ranks #5 of 133, 97th percentile; 76830 ranks #12 of 206, 95th percentile; 76815 ranks #11 of 124, 92nd percentile), indicating above-typical throughput for prenatal and diagnostic imaging.

The provider also reports an unusually high claim count for unclassified drug billing: J3490 appears 207.4K times for $622.3K in revenue and ranks #7 of 125 providers in-state (95th percentile). This pattern — very large claim volume but relatively modest revenue for the code — points to frequent billing of low-dollar drug items or catch-all drug entries across many encounters.

Across competitive standing measures, the hospital ranks at or above the 88th–97th percentiles for several high-volume Medicaid codes (for example, 99283 at the 97th percentile and 99284 at the 95th percentile), which characterizes it as a major in-state provider for emergency and related acute services. At the same time, many ancillary codes are in more typical percentile bands, so the facility’s dominance is concentrated in ED and infusion-related care rather than across all specialties.

The provider’s NPI was enumerated on 2006-09-16 (~20 years ago), indicating long tenure in the market. Combined with the concentrated Medicaid revenue base and lack of Medicare billing on file, this long-standing presence suggests operational stability but also exposure to Medicaid reimbursement trends and policy changes given the limited public-payer diversification.

Medicaid: Complete Services Breakdown

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

312 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.	70,210	$180	$12.7M
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.	45,710	$180	$8.4M
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.	24,010	$300	$7.2M
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.	25,950	$180	$4.6M
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.	17,580	$170	$2.9M
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.	10,120	$240	$2.4M
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.	10,380	$200	$2M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	8,090	$180	$1.5M
G0378	Hospital observation service, per hour	4,720	$200	$938.7K
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…	3,410	$270	$906K

Showing 1–10 of 312

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Potomac Hospital Corporation Of Prince William — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

312 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	12	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	62	70	3,200	$110	$2.8M
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.	39	340	160	$130	$1.3M
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	630	90	$140	$1.1M
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.	18	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	32	80	3,650	$160	$1M
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	620	70	$120	$1M
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.	32	180	2,950	$140	$783.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	84	260	3,950	$80	$769.6K
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.	35	170	3,390	$100	$658.8K

Showing 1–10 of 312

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
America's Best Home Healthcare LLC.	VA	Home Health Agency	$0	$15.8M
Blessed Support Professionals, Inc	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$14.9M
Whipple Tree Emergency Physicians LLC	VA	Emergency Medicine Physician	$0	$13.2M
Advanced Home Care Connect Inc	VA	Home Health Agency	$0	$12.4M
Provident Arc LLC	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$11.2M
Century Pediatrics Inc.	VA	Pediatrics Physician	$0	$10.9M
Divine Senior Home Care LLC	VA	Home Health Agency	$0	$9M
Quality Health Services, LLC	VA	Home Health Agency	$0	$7.7M
Abba Home Care LLC	VA	Home Health Agency	$0	$7.6M
Abien Home Care, Inc.	VA	Home Health Agency	$0	$7.2M

Potomac Hospital Corporation Of Prince William — Billing Profile & Reimbursement Data

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Potomac Hospital Corporation Of Prince William — 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

Nearby Providers

Frequently Asked Questions

References