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.

Sentara Hospitals (NPI 1629038336)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sentara Hospitals
Address	1060 First Colonial Rd
City	Virginia Beach
State	VA
ZIP	23454
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 25, 2006

Payer Source	Total Paid
Medicaid	$52.3M
Medicare	$0

This provider effectively operates as a Medicaid-centered hospital: there is no Medicare billing on file and reported Medicaid revenue totals $52.3M, making Medicaid the de facto single payer for the claims in this dataset. Analysts should treat comparisons and risk profiles accordingly, since Medicare activity cannot be used to benchmark breadth of services or revenue diversification.

Revenue is highly concentrated in a small set of ED and infusion-related codes: the precomputed top-3 Medicaid codes (99283, 99284, 96361) account for 51.8% of SENTARA HOSPITALS’ total Medicaid revenue. Those three codes alone represent $10.1M (99283), $7.8M (99284), and $6.2M (96361) of the $52.3M total, signaling a narrow set of high-impact services driving most Medicaid income.

The code mix strongly indicates an emergency-department–led operating model with substantial acute IV therapy capacity. High revenues for ED E/M codes — 99283 ($10.1M, 21.8%), 99284 ($7.8M, 16.8%), 99285 ($4.8M, 10.2%), and 99282 ($2.9M, 6.2%) — combined with infusion codes such as 96361 ($6.2M, 13.2%), 96360 ($691.7K), 96365 ($312.3K) and 96366 ($416.6K) point to frequent ED visits and repeated IV fluid/infusion treatments (dehydration and medication infusions) as core service lines.

Statewide competitive positioning is mixed but skewed toward high ED volume: 99283 ranks #26 of 626 providers in-state (96th percentile; notably above typical state volume), which identifies SENTARA HOSPITALS as one of the higher-volume providers for low-complexity ED visits in Virginia. Other ED codes such as 99284 (rank #33 of 620, 95th percentile) and 99285 (rank #34 of 340, 90th percentile) are also high-volume relative to peers, though the dataset tags some of those as "typical, unremarkable volume," suggesting the hospital fits within the expected ED footprint for a large acute-care center.

Ancillary diagnostic and imaging services form a meaningful secondary revenue stream consistent with an acute-care ED profile: CT and MRI codes (74177 $2.3M, 5.0%; 70450 $2.3M, 4.9%; 71275 $812.4K, 1.7%; 70553 $499.1K, 1.1%) appear across the top codes, indicating regular use of cross-sectional imaging to evaluate ED and inpatient presentations. These imaging volumes support an operational model that pairs high ED throughput with on-site diagnostic capability.

Endoscopy and procedural volumes are present but not dominant: upper endoscopy (43239 $1.2M, 2.5%) and colon procedures (45380 $780.1K, 1.7%; 45385 $540K, 1.2%; 45378 $375.5K, 0.8%) appear in the top Medicaid codes and rank in typical state percentiles (mostly mid- to high-80s), indicating SENTARA HOSPITALS maintains active GI procedural services appropriate for a general acute-care hospital but is not uniquely dominant in that niche statewide.

There are specific code-level outliers that signal above-typical throughput for certain support services: 94640 (oxygen/respiratory interventions) has 8.4K claims and $435.3K revenue and ranks #16 of 214 (93rd percentile; notably above typical state volume), while basic lab testing 80048 (BMP) shows 55.8K claims and $223.2K revenue and ranks #10 of 178 (95th percentile; notably above typical state volume). These flags point to consistently high ED/lab utilization and frequent respiratory interventions relative to in-state peers.

The provider has long-tenure enrollment (NPI enumerated 2006-03-25, ~20 years ago), suggesting an established presence in the Virginia Beach market. Combined with the concentrated Medicaid revenue base and the ED-heavy code mix, this tenure supports the view that SENTARA HOSPITALS is a stable, regionally significant acute-care and emergency-treatment provider serving a Medicaid-heavy patient population.

Medicaid: Complete Services Breakdown

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

287 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.	61,490	$170	$10.1M
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.	47,430	$170	$7.8M
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.	21,950	$280	$6.2M
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.	27,740	$170	$4.8M
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.	18,700	$160	$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.	12,180	$190	$2.3M
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.	12,560	$180	$2.3M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	2,200	$530	$1.2M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	22,180	$50	$1.1M
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…	3,220	$250	$812.4K

Showing 1–10 of 287

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

Sentara Hospitals — 1 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

287 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.	14	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	24	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.	34	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.	26	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.	16	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	41	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.	33	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.	19	180	2,950	$140	$783.2K
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.	27	170	3,390	$100	$658.8K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	32	80	1,510	$220	$512K

Showing 1–10 of 287

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
First Hospital Corporation Of Virginia Beach	VA	Psychiatric Hospital	$0	$22.4M
Sellati & Co., Inc.	VA	Methadone Clinic	$0	$5.6M
Lawrence Chang	VA	Dermatology Physician	$2.4M	$0
Eye Surgery Limited LLC	VA	Ambulatory Surgical Clinic/Center	$2.1M	$155.7K
Michael Cannon	VA	Specialist	$1.7M	$0
Janice Sherwood	VA	Rheumatology Physician	$1.4M	$0
Virginia Beach Ambulatory Surgery Center	VA	Ambulatory Surgical Clinic/Center	$240.6K	$797K
Aris Delianides	VA	Ophthalmology Physician	$644.6K	$11.2K
Steven Cronquist	VA	MOHS-Micrographic Surgery Physician	$573.7K	$0
Andrew Villanueva	VA	Dermatology Physician	$542.3K	$0

Sentara Hospitals — Billing Profile & Reimbursement Data

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Sentara Hospitals — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$88M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$79.7M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$78.5M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$57.9M
Sentara Hospitals	VA	General Acute Care Hospital	$0	$21.9M
Sentara Hospitals	VA	Air Ambulance	$977.3K	$170.6K
Michele Henry	VA	Chiropractor	$16.7K	$0