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.

Ohiohealth Corporation (NPI 1578545273)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ohiohealth Corporation
Address	3535 Olentangy River Rd
City	Columbus
State	OH
ZIP	43214
Taxonomy	Family Medicine Physician
NPI Enumerated	November 17, 2005

Payer Source	Total Paid
Medicaid	$89.1M
Medicare	$0

OHIOHEALTH CORPORATION is effectively a single‑payer Medicaid billing entity on file: Total Medicare revenue is listed as none while Total Medicaid revenue is $89.1M, indicating the organization’s measurable billing footprint in our dataset is concentrated entirely in Medicaid. This payer mix means analyses of reimbursement rates, utilization, and competitive standing should focus on Medicaid activity rather than Medicare comparisons.

Revenue is highly concentrated in a small set of evaluation-and-management codes: the top 3 Medicaid codes (99214, 99213, 99233) account for 66.7% of the provider’s Medicaid revenue. The lead codes are 99214 ($27.3M, 35.0% of Medicaid revenue), 99213 ($21.1M, 27.0%), and 99233 ($3.6M, 4.7%), so a large majority of dollars derive from office E/M and subsequent inpatient E/M services.

The code mix and volumes indicate a dominant ambulatory primary-care and outpatient visit operation: 99214 shows 535.4K claims at $51 avg paid/claim ($27.3M revenue) and 99213 shows 555.6K claims at $38 avg paid/claim ($21.1M revenue). These very large claim counts for established‑patient office visits point to extremely high outpatient throughput and a business model built around visit volume for ongoing management of patients.

Beyond outpatient care, the provider reports substantial inpatient and acute-care activity. Codes for subsequent hospital care such as 99233 (125.8K claims, $29 avg paid/claim, $3.6M) and 99232 (172.8K claims, $20 avg paid/claim, $3.5M) and high-acuity codes like 99291 (39.9K claims, $52 avg paid/claim, $2.1M) together suggest integrated inpatient/observation and critical care services are significant components of operations rather than a pure clinic-only practice.

The provider occupies a dominant competitive position statewide on numerous codes, frequently appearing as an extreme outlier. Examples include 99214 (ranks #6 of 4514, 100th percentile; extreme outlier), 99213 (ranks #8 of 5077, 100th percentile; extreme outlier), 99232 (ranks #1 of 919, 100th percentile; extreme outlier), 76811 (ranks #1 of 89, 100th percentile; extreme outlier), and multiple other codes at top percentile ranks, indicating market-leading volumes across both outpatient E/M and procedure/imaging categories.

The provider also shows a significant procedural and diagnostic footprint alongside E/M visits: 93306 (53.7K claims, $34 avg paid/claim, $1.8M revenue; ranks #2 of 328, 100th percentile; extreme outlier), 93010 (165K claims, $7 avg paid/claim, $1.2M revenue; ranks #5 of 450, 99th percentile; extreme outlier), and obstetric imaging 76811 (16.1K claims, $69 avg paid/claim, $1.1M revenue; ranks #1 of 89, 100th percentile; extreme outlier). This mix points to integrated diagnostic services supporting both outpatient and inpatient care lines.

From a business‑risk and negotiation perspective, the heavy dependence on a few high‑volume E/M codes (top 3 = 66.7% of Medicaid revenue) signals revenue concentration that could materially affect finances if utilization patterns, coding policy, or Medicaid reimbursement change. For downstream analytics or contracting, focus on 99214 and 99213 utilization trends and reimbursement rates will capture the bulk of revenue movement.

OHIOHEALTH’s NPI tenure is long-standing: enumerated 2005-11-17 (~21 years ago). That sustained presence combined with very large Medicaid volumes suggests established referral relationships and operational scale within the state Medicaid market rather than a recently entered or small practice footprint.

Medicaid: Complete Services Breakdown

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

352 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	535,410	$50	$27.3M
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…	555,570	$40	$21.1M
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…	125,790	$30	$3.6M
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…	172,820	$20	$3.5M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	41,670	$60	$2.5M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	39,950	$50	$2.1M
99203	The provider sees a new 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 provider…	43,740	$50	$2M
99204	The provider sees a new 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 provider…	29,050	$70	$2M
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…	53,750	$30	$1.8M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	164,980	$10	$1.2M

Showing 1–10 of 352

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

Ohiohealth Corporation — 20 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

352 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	324	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.	315	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.	471	580	510	$100	$1.3M
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	62	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	15	60	250	$730	$707.7K
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.	130	230	2,200	$100	$530.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,829	2,640	620	$90	$408.2K
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…	6	4,510	500	$60	$377.8K
95720	A physician or other QHCP reviews recorded events and analyzes spike and seizure detection of a continuous electroencephalography, a study of the electrical activity of the brain. A video is…	2	30	1,060	$120	$372K
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…	8	5,080	560	$40	$323.9K

Showing 1–10 of 352

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Cleveland Clinic Foundation	OH	General Acute Care Hospital	$0	$864.1M
Nationwide Children's Hospital	OH	General Acute Care Hospital	$0	$777.8M
Ohiohealth Corporation	OH	General Acute Care Hospital	$0	$215.2M
University Physicians Incorporated	CO	Internal Medicine Physician	$0	$190.8M
University Hospitals Medical Group Inc	OH	Multi-Specialty Clinic/Center	$0	$107.5M
Utmb Faculty Group Practice	TX	General Practice Physician	$0	$98.9M
University Medical Center Of Southern Nevada	NV	General Acute Care Hospital	$0	$95.5M
University Primary Care Practices Inc	OH	Internal Medicine Physician	$0	$78.7M
Ohiohealth Corporation	OH	General Acute Care Hospital	$0	$76.9M
Ohiohealth Corporation	OH	General Acute Care Hospital	$0	$72.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Clinical Medical Laboratory	$0	$44.3M
Riverside Radiology And Interventional Associates Inc	OH	Diagnostic Radiology Physician	$0	$30.3M
Compassus Ohiohealth Columbus Hospice, LLC	OH	Community Based Hospice Care Agency	$0	$19.4M
Central Ohio Hospitalists, Inc	OH	Specialist	$0	$11.7M
Ohio Surgery Center LLC	OH	Ambulatory Surgical Clinic/Center	$227.8K	$1.1M
Clem Kirkland	OH	Dermatology Physician	$725.1K	$0
Thomas Sweeney	OH	Medical Oncology Physician	$712K	$0
Jason Seavolt	OH	Radiation Oncology Physician	$695.3K	$0
Jarred Burkart	OH	Hematology & Oncology Physician	$659.8K	$0
Kavya Krishna	OH	Hematology & Oncology Physician	$565.3K	$0

Ohiohealth Corporation — 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