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.

Carilion Franklin Memorial Hospital (NPI 1710970918)

Carilion Franklin Memorial Hospital is a general acute care hospital provider located in Rocky Mount, Virginia. This profile covers 0 Medicare and 194 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	Carilion Franklin Memorial Hospital
Address	180 Floyd Ave
City	Rocky Mount
State	VA
ZIP	24151
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 24, 2005

Payer Source	Total Paid
Medicaid	$18.4M
Medicare	$0

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

194 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.	20,450	$180	$3.6M
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.	16,830	$180	$3M
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.	8,260	$290	$2.4M
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.	10,560	$190	$2M
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.	6,460	$160	$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.	4,300	$220	$963K
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…	12,600	$50	$680.2K
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.	3,320	$160	$535.2K
0241U	N/A	6,310	$70	$422.6K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	2,220	$150	$333.4K

Showing 1–10 of 194

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

Carilion Franklin Memorial Hospital — 0 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

194 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.	50	90	9,030	$280	$3.2M
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.	78	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.	72	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.	46	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	78	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.	87	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.	75	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.	88	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.	44	80	1,510	$220	$512K
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.	53	110	2,780	$110	$471.1K

Showing 1–10 of 194

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carilion Medical Center	VA	General Acute Care Hospital	$0	$124.7M
Carilion Medical Center	VA	Multi-Specialty Clinic/Center	$0	$73.4M
Carilion New River Valley Medical Center	VA	General Acute Care Hospital	$0	$32.4M
Carilion Healthcare Corporation	VA	Multi-Specialty Clinic/Center	$0	$26.1M
Carilion Medical Center	VA	Emergency Medicine Physician	$0	$18.1M
Jefferson Radiology, PC	CT	Diagnostic Radiology Physician	$0	$14M
Stonewall Jackson Memorial Hospital Company	WV	Rural Acute Care Hospital	$0	$13M
Carilion Rockbridge Community Hospital	VA	Critical Access Hospital	$0	$11.8M
Carilion Emergency Services, Inc.	VA	Urgent Care Clinic/Center	$0	$11.1M
Carilion Giles Community Hospital	VA	Critical Access Hospital	$0	$10.3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Franklin Co Board Of Supervisors	VA	Land Ambulance	$566.1K	$989K
Timothy Beirne	VA	Family Medicine Physician	$133.6K	$4.9K
Mohammed Bermo	VA	Diagnostic Radiology Physician	$109.9K	$0
Angela Bowman	VA	Physician Assistant	$31.6K	$0

Carilion Franklin Memorial Hospital — Billing Profile & Reimbursement Data

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Carilion Franklin Memorial Hospital — 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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