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

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

Shands Teaching Hospital And Clinics Inc (NPI 1699874248)

Field	Value
Entity Type	Organization
Organization	Shands Teaching Hospital And Clinics Inc
Address	1600 Sw Archer Rd
City	Gainesville
State	FL
ZIP	32610
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$92M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused hospital: there is no Medicare billing on file while reported Medicaid revenue totals $92M, so Medicaid is the primary payer driving the facility’s reported activity. The NPI was enumerated 2006-09-21 (~20 years ago), indicating a long-standing presence in the market but with current billing concentrated in Medicaid dollars rather than Medicare.

Emergency department evaluation-and-management codes are the single-largest individual revenue drivers on Medicaid. 99284 generated $5.4M (11.1% of Medicaid revenue), 99283 generated $4.6M (9.6%), and 99285 generated $3.7M (7.7%); those three ED codes together are responsible for 28.5% of this provider’s total Medicaid revenue (precomputed). The claim volumes for these ED codes are large (66.9K, 70.5K, 33.5K claims respectively), signaling a high ED throughput as a core operating line.

The provider shows outsized ambulatory rehabilitation and therapy activity on Medicaid, with 97530 reporting 65.5K claims and $3.5M revenue (7.2% of Medicaid revenue) and 97110 reporting 63.5K claims and $2.9M revenue (6.1%). Both codes rank in the 99th percentile and 97530 is labeled an extreme outlier, which indicates this hospital is a regional hub for physical therapy/rehabilitation services to Medicaid patients. This concentration suggests a meaningful service-line emphasis on therapy that complements high ED volume.

Infusion and chemotherapy services are another material service line: 96361 ($2.1M, 4.3%), 96365 ($1.4M, 2.8%) and 96413 ($1.3M, 2.7%) all appear on the top-code list, and 96365 ranks #2 of 232 providers in-state with a 100th-percentile flag (extreme outlier). J1745 (infliximab) generated $1.4M (3.0%) and ranks #1 of 14 providers (100th percentile), while J3380 (vedolizumab) also ranks #1 of 3 providers (100th percentile). Together these entries point to substantial biologic and infusion throughput, consistent with oncology, gastroenterology, or autoimmune disease treatment capacity.

The provider is a clear in-state leader for several specialized procedures: 54161 (circumcision) generated $2M (4.2%) and ranks #1 of 44 providers (100th percentile; extreme outlier), while J1745 and J3380 also carry #1 ranks for their drug administrations. These #1 rankings and extreme-outlier labels indicate market dominance for specific procedural and specialty drug services within Florida Medicaid. At the same time, several high-volume ED and imaging codes are placed in the mid‑to‑high percentiles (95th–97th), showing strong but sometimes characterized as typical state volumes rather than unique specialties.

Diagnostic, imaging, and cardiac testing make up a meaningful portion of Medicaid revenue as well: 80053 (CMP) shows $2.5M (5.2%), 93306 (echocardiography) shows $1.5M (3.0%), and 74177 (CT abdomen/pelvis with contrast) shows $1.3M (2.8%). These codes rank in the 95th–97th percentiles for in-state peers, indicating the hospital performs high volumes of routine lab and advanced imaging services for Medicaid patients—supporting both acute care and outpatient diagnostic workflows.

There is a mixed competitive standing across services: several codes are labeled extreme outlier or 100th percentile (e.g., 97530, 97110, 54161, 96365, J1745) which signals the hospital is a dominant in-state provider for those specific services, while several high-revenue ED codes (99284, 99285) are described as typical or unremarkable despite very large claim counts and top-dollar contribution. In practice this means the hospital combines specialty dominance in certain lines (therapy, infusion, select procedures) with broad, high-volume acute care operations that track with large academic or regional referral hospitals.

Several statistical outlier flags reinforce distinct service concentrations: 97530 and 97110 are labeled extreme outliers (99th percentile) for physical therapy; 96365 shows a 100th‑percentile extreme‑outlier designation for infusion starts; and 54161 and multiple biologic drug codes (J1745, J3380) carry 100th‑percentile or similarly elevated ranks. These labels point to unusually high Medicaid volumes in targeted procedure, therapy, and infusion services rather than a uniform elevation across all code families, which should inform payer negotiations, network strategy, and utilization reviews focused on those concentrated lines.

Medicaid: Complete Services Breakdown

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

794 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.	66,950	$80	$5.4M
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.	70,450	$70	$4.6M
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.	33,530	$110	$3.7M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	65,510	$50	$3.5M
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…	63,490	$50	$2.9M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	100,320	$30	$2.5M
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.	22,950	$90	$2.1M
54161	The provider excises the foreskin of a patient older than 28 days; the provider uses a technique other than a clamp, other devices, or dorsal slit.	2,460	$830	$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…	21,710	$80	$1.7M
0241U	N/A	16,650	$100	$1.7M

Showing 1–10 of 794

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Shands Teaching Hospital And Clinics Inc — 16 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

794 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	152	160	4,450	$110	$1.5M
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.	35	700	2,400	$80	$1.2M
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.	27	740	2,180	$70	$1.1M
J9271	Injection, pembrolizumab, 1 mg	6	10	630	$1,300	$977.3K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	1	10	710	$850	$915.3K
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.	36	660	1,900	$70	$743.6K
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	3	10	1,510	$190	$692.6K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	4	30	310	$720	$616.3K
J3262	Injection, tocilizumab, 1 mg	4	10	170	$1,470	$480.8K
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.	32	320	1,970	$90	$463.1K

Showing 1–10 of 794

Related Providers

Other providers that share a Tax Identification Number (TIN) with Shands Teaching Hospital And Clinics Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Shands Teaching Hospital And Clinics Inc	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$17.7M

Nearby Providers

Other providers in the same ZIP code as Shands Teaching Hospital And Clinics Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Florida Clinical Practice Association Inc	FL	Surgery Physician	$0	$79.3M
Siva Iyer	FL	Ophthalmology Physician	$1.3M	$0
William Mendenhall	FL	Radiation Oncology Physician	$731.9K	$0
Matthew Steadmon	FL	Dermatology Physician	$670.4K	$0
Yusuf Aref	FL	Anesthesiology Physician	$619.8K	$0
Ahmaida Zeglam	FL	Ophthalmology Physician	$564.8K	$0
Irene Malaty	FL	Neurology Physician	$526.8K	$0
Sebastian Carrasquillo Montalvo	FL	Cardiovascular Disease Physician	$422.7K	$0
Alfredo Farinas	FL	Internal Medicine Physician	$318K	$0
Christopher West	FL	Urology Physician	$315.5K	$0

Shands Teaching Hospital And Clinics Inc — Billing Profile & Reimbursement Data

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Shands Teaching Hospital And Clinics 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