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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Nash Hospitals Inc (NPI 1619969219)

Key Findings

Field	Value
Entity Type	Organization
Organization	Nash Hospitals Inc
Address	2460 Curtis Ellis Dr
City	Rocky Mount
State	NC
ZIP	27804
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 19, 2005

Payer Source	Total Paid
Medicaid	$42.4M
Medicare	$0

NASH HOSPITALS INC shows an effectively single-payer Medicaid footprint: there is no Medicare billing on file while lifetime Medicaid revenue is $42.4M, and the provider’s NPI has been enumerated since 2005-08-19 (~21 years ago), indicating long-standing participation in the Medicaid program. This combination points to an established facility whose publicly visible reimbursement activity is concentrated in Medicaid.

Revenue concentration is highly focused in emergency department evaluation-and-management codes: the top three Medicaid codes 99284 ($11.6M, 29.2%), 99283 ($10.7M, 27.0%), and 99285 ($5.4M, 13.5%) together account for 69.8% of the provider’s total Medicaid revenue. That precomputed share signals the hospital’s financial profile is dominated by ED visits rather than by inpatient Medicare billing or other outpatient specialty lines.

The code mix and claim volumes confirm an ED-centric operating model. High claim counts for ED codes (99283: 60.4K claims; 99284: 50.8K claims; 99285: 21.3K claims) and average paid/claim levels (99284 $229, 99283 $178, 99285 $253) indicate the hospital manages very large ED throughput across low, moderate, and high complexity visits, which drives the majority of Medicaid revenue.

Competitive standing within North Carolina is mixed but leans toward strong ED volume: 99283 ranks #24 of 316 providers in-state (93th percentile; notably above typical state volume), 99284 ranks #35 of 325 (90th percentile; typical, unremarkable volume), and 99285 ranks #46 of 281 (84th percentile; typical, unremarkable volume). These rankings suggest NASH HOSPITALS is a meaningful regional ED provider—particularly for the 99283-level visits—though it is not uniformly dominant across all ED complexity levels.

Ancillary and diagnostic services support the ED-heavy model: significant Medicaid revenue items include 93005 ($857.4K, 2.2%), 70450 ($731.9K, 1.8%), 74177 ($695.3K, 1.7%), and comprehensive lab panels 80053 ($484.9K, 1.2%) and CBC 85025 ($462.8K, 1.2%). The presence of CT imaging, EKGs, and high-volume lab testing aligns with an acute care hospital delivering on-site diagnostics for emergency and urgent presentations.

Several codes are statistical outliers or notably above typical state volume, pointing to operational emphases beyond standard ED care: 81025 ranks #6 of 574 providers in-state (99th percentile; extreme outlier) indicating exceptionally high pregnancy test volume; 0241U ranks #11 of 136 (93th percentile; notably above typical); 93005 ranks in the 96th percentile and 96361 in the 95th percentile (both notably above typical). These high-percentile placements imply concentrated delivery of particular quick-turnaround diagnostics and IV-related services.

The provider also bills for a range of specialty and procedural services beyond urgent care: dental/odontology-related 41899 ($739.2K, 1.9%), cataract extraction 66984 ($362.2K, 0.9%), and chemotherapy administration 96413 ($355.1K, 0.9%) appear in the top code list. While none of these rival the ED codes in revenue share, their presence indicates the facility operates multiple outpatient procedural lines and oncology/ophthalmology or surgical throughput to a meaningful — if secondary — extent.

Operationally, NASH HOSPITALS’ Medicaid revenue profile shows dependence on very high claim volumes of lower-paid services (routine labs and testing such as 80053 and 85025 with high claim counts and low avg paid/claim) combined with high-volume E/M visits. That mix suggests revenue sensitivity to Medicaid ED utilization patterns and testing throughput, and indicates payer/contracting or utilization-management levers should focus on ED case mix, lab utilization, and high-frequency test categories (for example 81025) when assessing financial or network strategies.

Medicaid: Complete Services Breakdown

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

155 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	50,780	$230	$11.6M
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.	60,380	$180	$10.7M
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.	21,270	$250	$5.4M
0241U	N/A	13,000	$160	$2M
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.	10,870	$110	$1.2M
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	29,560	$30	$857.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	460	$1,590	$739.2K
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.	3,330	$220	$731.9K
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.	960	$720	$695.3K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	9,800	$60	$538.7K

Showing 1–10 of 155

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Nash Hospitals Inc — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

155 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.	35	330	6,130	$130	$2.7M
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…	39	160	840	$70	$2.3M
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.	24	320	6,160	$120	$2.1M
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.	46	280	2,690	$130	$1.6M
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	23	40	220	$60	$920.5K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	18	40	420	$1,080	$841K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	169	360	1,830	$40	$819.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	27	90	4,210	$30	$676.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	98	190	530	$20	$635.1K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	98	190	560	$20	$609.8K

Showing 1–10 of 155

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Browder	NC	Internal Medicine Physician	$245K	$0
Douglas Slater	NC	Internal Medicine Physician	$194.2K	$0
Martha Chesnutt	NC	Internal Medicine Physician	$192.5K	$0
Charles Jere	NC	Nephrology Physician	$165.5K	$0
Robert Schellenberg	NC	Gastroenterology Physician	$117.7K	$0
Sudhir Prasada	NC	Interventional Cardiology Physician	$82.7K	$0
David Garza	NC	Certified Registered Nurse Anesthetist	$31.1K	$0
Kirsten Ashby	KY	Certified Registered Nurse Anesthetist	$28.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Educare Community Living Corporation - North Carolina	NC	Community/Behavioral Health Agency	$0	$69.3M
Boice-willis Clinic PA	NC	Internal Medicine Physician	$0	$27.8M
Wake Emergency Physicians PA	NC	Emergency Medicine Physician	$0	$8.8M
Opportunities Industrialization Center, Inc.	NC	Federally Qualified Health Center (FQHC)	$0	$8.1M
County Of Nash	NC	Land Ambulance	$1M	$2.3M
County Of Halifax	NC	Land Ambulance	$495.6K	$2.3M
Boice-willis Clinic, PA	NC	Clinical Medical Laboratory	$509.1K	$735.1K
Karn Gupta	NC	Nephrology Physician	$944.8K	$0
Aristides Assimacopoulos	NC	Infectious Disease Physician	$360.7K	$450.7K
Metz Medical Transport, Inc.	NC	Land Ambulance	$363.8K	$212.1K

Nash Hospitals Inc — 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