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.

University Hospitals Medical Group Inc (NPI 1669499414)

Field	Value
Entity Type	Organization
Organization	University Hospitals Medical Group Inc
Address	11100 Euclid Ave
City	Cleveland
State	OH
ZIP	44106
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 17, 2006

Payer Source	Total Paid
Medicaid	$107.5M
Medicare	$0

Key Findings

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file while lifetime Medicaid revenue is $107.5M. The NPI was enumerated on 2006-07-17 (~20 years ago), indicating a long-tenured presence in the market.

Revenue is highly concentrated in a small set of outpatient E/M codes: the precomputed top three Medicaid codes (99214, 99284, 99213) account for 42.1% of total Medicaid revenue. Specifically, 99214 generates $12.9M (17.4%), 99284 generates $9.8M (13.2%), and 99213 generates $8.6M (11.5%), highlighting those codes as primary revenue drivers.

The code mix indicates a large emergency and acute care footprint: 99284 ($9.8M) ranks #9 of 655 in‑state (99th percentile; extreme outlier) and 99285 ($7.3M) ranks #14 of 581 (98th percentile; notably above typical state volume). High volumes of ED-level E/M codes alongside 99291 ($1.1M, 98th percentile; notably above typical) suggest substantial emergency and critical care throughput.

Imaging and diagnostics are a major service line: CT of the head 70450 accounts for $3.1M and ranks #3 of 286 (99th percentile; extreme outlier), CT abdomen/pelvis 74177 is $3M and ranks #3 of 280 (99th percentile; extreme outlier), and multiple chest x‑ray codes (71045 $1.7M, 71046 $1.1M) also rank at or near the top of state peers. The presence of CTA 71275 ($1.2M, 99th percentile; notably above typical) and brain MRI 70553 ($1.1M, 97th percentile; extreme outlier) further point to a large imaging footprint supporting ED and inpatient care.

Perinatal and neonatal services are meaningful contributors: neonatal critical care subsequent care 99469 yields $2.4M (3.2%) and ranks #5 of 13 (67th percentile; typical), direction of care for low birth weight infants 99479 yields $1.6M (2.2%) and ranks #2 of 15 (93rd percentile; typical), and 99472 yields $1.4M (1.9%) and ranks #4 of 14 (77th percentile; typical). High volumes of fetal ultrasound codes—76816 ($1.3M, 99th percentile; extreme outlier) and 76811 ($982.7K, 99th percentile; extreme outlier)—reinforce substantial obstetric and NICU activity.

Laboratory, pathology and cardiac testing are also prominent: surgical pathology 88305 produces $3M (4.0%) and ranks #3 of 336 (99th percentile; extreme outlier), transthoracic echo 93306 produces $1.1M and ranks #6 of 328 (98th percentile; extreme outlier), and long‑term EEG interpretation 95720 produces $1.1M and ranks #3 of 25 (92nd percentile; typical). This mix signals significant inpatient and specialty diagnostic support consistent with a large multispecialty center.

Statewide competitive standing is strong across many Medicaid codes: multiple high‑revenue codes appear in the 99th–100th percentile (e.g., 99214 at the 100th percentile and 70450, 74177, 76816 at the 99th percentile), indicating the provider is a dominant Medicaid performer in Ohio for those services. The absence of Medicare billing on file, however, prevents any national Medicare comparison and makes Medicaid performance the primary basis for competitive analysis in this profile.

Operational and revenue concentration implications are evident given that the top three Medicaid codes represent 42.1% of Medicaid revenue and that acute E/M, imaging, perinatal, and pathology codes recur among top earners. This concentration suggests that changes in Medicaid policies, ED utilization, or imaging utilization/pricing would disproportionately impact the provider’s financials and strategic priorities.

Medicaid: Complete Services Breakdown

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

489 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…	286,960	$50	$12.9M
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.	178,110	$60	$9.8M
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…	260,050	$30	$8.6M
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.	95,850	$80	$7.3M
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.	117,900	$30	$3.1M
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.	81,340	$40	$3M
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	62,960	$50	$3M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	7,860	$300	$2.4M
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…	67,630	$30	$2.2M
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	41,120	$50	$2.1M

Showing 1–10 of 489

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

University Hospitals Medical Group Inc — 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

489 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.	48	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.	9	660	460	$90	$1.5M
J0178	Injection, aflibercept, 1 mg	8	20	310	$1,070	$1.4M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	5	10	1,020	$280	$1.3M
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.	14	580	510	$100	$1.3M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	4	10	480	$290	$1.2M
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	20	4,730	$90	$818.4K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	6	20	1,320	$90	$727.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	9	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	34	60	250	$730	$707.7K

Showing 1–10 of 489

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Hospitals Medical Group Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
University Primary Care Practices Inc	OH	Internal Medicine Physician	$0	$78.7M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Partners Physician Group	OH	Surgery Physician	$0	$28.5M
Behavior Health & Wellness Center, LLC	VA	Behavior Analyst	$0	$15.8M
Lake Hospital System Inc	OH	Family Medicine Physician	$0	$6.9M
Jennifer Muller	FL	Medical Oncology Physician	$1.9M	$0
Amjad Safvi	IL	Vascular & Interventional Radiology Physician	$568.9K	$765.4K
Ashley Simmons	OH	Nurse Practitioner	$783.1K	$0
Kourosh Naeini	CA	Diagnostic Radiology Physician	$709.1K	$120

Nearby Providers

Other providers in the same ZIP code as University Hospitals Medical Group Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Hospitals Cleveland Medical Center	OH	General Acute Care Hospital	$0	$156.9M
University Hospitals Cleveland Medical Center	OH	Children's Hospital	$0	$76.7M
University Hospitals Laboratory Services Foundation	OH	Clinical Medical Laboratory	$8.4M	$41.1M
Circle Health Services	OH	Federally Qualified Health Center (FQHC)	$0	$7.1M
Community Dialysis Center	OH	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7M
Adir Ludin	OH	Radiation Oncology Physician	$1.6M	$0
Katarzyna Brodowska	OH	Ophthalmology Physician	$929.6K	$162.9K
Eric Palfreyman	OH	Internal Medicine Physician	$1M	$0
Shree Kurup	OH	Ophthalmology Physician	$533.2K	$0
Roy Raad	OH	Diagnostic Radiology Physician	$459.2K	$46.8K

University Hospitals Medical Group 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