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

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

Baptist Health Regional Hospitals (NPI 1710463146)

Key Findings

Field	Value
Entity Type	Organization
Organization	Baptist Health Regional Hospitals
Address	1001 Towson Ave
City	Fort Smith
State	AR
ZIP	72901
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 18, 2018

Payer Source	Total Paid
Medicaid	$17.5M
Medicare	$0

BAPTIST HEALTH REGIONAL HOSPITALS reports no Medicare billing on file and $17.5M in lifetime Medicaid revenue, with an NPI enumerated on 2018-07-18 (~8 years ago). This makes its public claims footprint effectively single‑payer (Medicaid) in the available data, so all utilization and competitive observations below reflect its Medicaid activity only.

Revenue is concentrated: the precomputed top three Medicaid codes (99283, 11042, 0241U) account for 31.9% of the provider's total Medicaid revenue. Those three codes are 99283 ($1.4M, 11.8%), 11042 ($1.3M, 11.4%), and 0241U ($1M, 8.7%), indicating a relatively high share of revenue driven by a small set of procedures/tests.

The code mix signals a full‑service acute hospital with heavy emergency, wound/debridement and diagnostic throughput. Emergency E/M codes 99283 (11.6K claims, $1.4M) and 99284 (6.8K claims, $663.9K) rank notably in-state, while surgical debridement 11042 (13.9K claims, $1.3M) is one of the top revenue drivers, together with high volumes of imaging (74177, 70450) and common lab panels (80053, 80048, 85025).

State competitive standing is mixed but includes clear dominance in specific procedures. The provider ranks #1 of 56 for 11042 (100th percentile; extreme outlier) and #3 of 248 for 96372 (99th percentile; extreme outlier), while other high-volume services such as U0003 (rank #4 of 81, 96th percentile) and several lab and imaging CPTs (multiple codes in the 92–97th percentiles) place it well above typical in-state volumes for those services.

Operational implications of the claims volume point to high ED and diagnostic throughput plus infusion/oncology activity. Large claim counts for routine labs and diagnostics (85025: 50.3K claims, 80053: 36.5K claims, 93005: 26.7K claims) alongside chemotherapy/infusion codes 96413 (4.1K claims, $436.6K) and 96365 (7K claims, $418.3K) indicate steady inpatient/emergency testing and outpatient infusion capacity.

Several specific codes are statistical outliers or notably above typical state volume and warrant follow-up for capacity and contracting strategy. In addition to 11042 and 96372 labeled “extreme outlier,” high percentile placements include 0241U (rank #3 of 39, 95th percentile), U0003 (rank #4 of 81, 96th percentile), and 85025 (rank #12 of 331, 97th percentile), suggesting concentrated expertise or referral patterns for those services.

The presence of 0241U as a top-three revenue driver (10K claims, $1M) despite no descriptor in the file is operationally material; analysts should identify what 0241U represents (a specialized test or procedure) because it significantly contributes to the 31.9% top‑three concentration. Understanding that code will be important for contract negotiations, capacity planning, or network inclusion decisions.

Because there is no Medicare billing on file, comparisons to national Medicare peers are not possible from these data and any market or performance benchmarking should be limited to Medicaid and in‑state peers. Analysts should treat observed Medicaid rankings and concentrations as representative of this provider’s Medicaid business only and consider seeking complementary sources if Medicare performance or broader payer mix is needed.

Medicaid: Complete Services Breakdown

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

333 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.	11,560	$120	$1.4M
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	13,880	$100	$1.3M
0241U	N/A	10,000	$100	$1M
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…	9,130	$90	$775.7K
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.	6,220	$120	$758.2K
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.	36,500	$20	$693.6K
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.	7,750	$90	$666.2K
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.	6,770	$100	$663.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	4,080	$110	$436.6K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	6,970	$60	$418.3K

Showing 1–10 of 333

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arkansas Distribution

Baptist Health Regional Hospitals — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

333 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	205	530	4,960	$70	$2.6M
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.	473	580	3,620	$60	$712.7K
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…	136	500	3,410	$60	$523.5K
0241U	N/A	3	40	1,640	$120	$370.5K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	5	30	530	$150	$342.5K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	17	40	160	$280	$278.1K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	15	40	360	$300	$254.1K
80047	The lab analyst performs a basic metabolic panel (BMP) test in which he measures the blood level of eight chemicals identified in the descriptor including ionized calcium, sodium, potassium,…	3	10	1,710	$30	$233K
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.	29	190	1,780	$50	$231.9K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	7	20	130	$450	$212.1K

Showing 1–10 of 333

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vent S Murphy Dds Ms PLLC	AR	Pediatric Dentistry	$0	$19.7M
River Valley Pediatric Dentistry PLLC	AR	Pediatric Dentistry	$0	$9.7M
University Of Arkansas For Medical Sciences	AR	Developmental - Behavioral Pediatrics Physician	$0	$9.2M
Lhcg Civ, LLC	AR	In Home Supportive Care Agency	$0	$5.2M
Abilities Unlimited Of Fort Smith Inc	AR	Non-emergency Medical Transport (VAN)	$0	$4.9M
Area Agency On Aging Of Western Arkansas, Inc	AR	Home Health Agency	$0	$3.9M
University Of Arkansas For Medical Sciences	AR	Family Medicine Physician	$0	$3M
Fort Smith Hma, LLC	AR	General Acute Care Hospital	$0	$2.4M
Area Agency On Aging Of Western Arkansas, Inc	AR	Home Health Agency	$0	$1.8M
Area Agency On Aging On Aging	AR	Home Health Agency	$0	$1.7M

Baptist Health Regional 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
Baptist Health Services	AR	Family Medicine Physician	$0	$9.9M
Baptist Health Regional Hospitals	AR	General Acute Care Hospital	$0	$2.5M