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.

Mount Carmel Health System (NPI 1710067376)

Mount Carmel Health System is a general acute care hospital provider located in Grove City, Ohio. This profile covers 0 Medicare and 161 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Mount Carmel Health System
Address	5300 N Meadows Dr
City	Grove City
State	OH
ZIP	43123
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 17, 2006

Payer Source	Total Paid
Medicaid	$14.4M
Medicare	$0

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

161 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.	37,110	$90	$3.5M
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.	30,170	$100	$3.1M
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.	12,420	$110	$1.4M
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	17,110	$80	$1.4M
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.	13,030	$80	$1.1M
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.	6,440	$160	$1M
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	38,130	$20	$648.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,660	$100	$377.4K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	2,170	$90	$199.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3,390	$50	$182.8K

Showing 1–10 of 161

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

Mount Carmel Health System — 1 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

161 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	105	150	4,030	$100	$5.9M
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.	66	170	4,660	$300	$2.6M
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.	81	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.	104	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.	127	580	510	$100	$1.3M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	21	50	220	$30	$675.9K
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.	186	290	1,380	$90	$635.2K
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.	237	280	1,110	$110	$605.7K
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.	30	230	2,200	$100	$530.1K
G0378	Hospital observation service, per hour	76	160	2,840	$80	$529.2K

Showing 1–10 of 161

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$66.7M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$42.4M
Mount Carmel Healthproviders Inc	OH	Family Medicine Physician	$0	$9.5M
Trinity Home Health Services	OH	Community Based Hospice Care Agency	$0	$8.9M
Mount Carmel Health System	OH	Sleep Disorder Diagnostic Clinic/Center	$73.8K	$402.6K
Joel Politi	OH	Orthopaedic Surgery Physician	$351.7K	$0
Emal Sherzai	OH	Internal Medicine Physician	$251.1K	$0
Derek Snook	OH	Orthopaedic Surgery of the Spine Physician	$243.5K	$0
Mark Knapp	OH	Hematology & Oncology Physician	$223K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jackson Township Franklin County	OH	Ambulance	$379.5K	$1.2M
Dean Hearne	OH	Dermatology Physician	$305K	$0
Ryan Carlson	OH	Dermatology Physician	$204.2K	$0
Justin Weiner	OH	Clinical Cardiac Electrophysiology Physician	$185.6K	$0
Jeffrey Backes	OH	Sports Medicine (Orthopaedic Surgery) Physician	$159.3K	$0
Timothy Walter	OH	Specialist	$98.9K	$0
Theodore Pollock	OH	Hematology & Oncology Physician	$98.3K	$0
Thura Harfi	OH	Cardiovascular Disease Physician	$98.1K	$0
Ravish Shah	OH	Nephrology Physician	$85.2K	$0
Nicholas Stoycheff	OH	Nephrology Physician	$77.7K	$0

Mount Carmel Health System — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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