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

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

St Elizabeth Medical Center, Inc (NPI 1740221795)

Field	Value
Entity Type	Organization
Organization	St Elizabeth Medical Center, Inc
Address	85 N Grand Ave
City	Fort Thomas
State	KY
ZIP	41075
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 9, 2006

Payer Source	Total Paid
Medicaid	$46M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused hospital in the available dataset: Medicare revenue is reported as "none" while total Medicaid revenue is $46M, so the observable commercial/public payer mix here is essentially single‑payer Medicaid. Analysts should treat any Medicare comparisons as inapplicable for this entity because there is no Medicare billing on file.

Revenue concentration is high: the precomputed top three Medicaid codes account for 54.8% of the provider's Medicaid revenue. Those top codes are 99283 ($7.5M, 19.1%), 41899 ($7.1M, 18.2%), and 99284 ($6.9M, 17.5%), indicating a small number of services drive a majority of reported Medicaid dollars.

The code mix points to a hospital with heavy emergency department activity and substantial procedural dental/oral services. High-volume ED E/M codes 99283 (31.9K claims, $7.5M) and 99284 (19.7K claims, $6.9M), along with 99285 (11.5K claims, $4.5M), show a broad distribution of acuity levels treated in the ED, while 41899 ($7.1M) indicates a significant revenue line for procedures on teeth or adjacent alveolar structures billed in hospital settings.

Beyond the ED and dental-related codes, the provider reports meaningful activity in IV/infusion therapies and hospital observation: 96374 ($1.6M), 96361 ($667.2K), 96365 ($441.3K) and G0378 ($1.5M). Imaging and diagnostic services also appear consistently across the top codes (74177 $1.4M, 70450 $401.1K, 71046 $440.6K), supporting a full-service acute care hospital model with on‑site imaging and infusion capacity.

State-level competitive standing is mixed but generally concentrated in the mid‑to‑upper percentiles for key codes: 99283 ranks #38 of 284 (87th percentile) and 99284 ranks #77 of 282 (73rd percentile), indicating solid ED volume relative to in‑state peers but not a statewide dominance. 41899 ranks #8 of 42 (83rd percentile) for in‑state providers, which places the hospital toward the upper tier among the smaller group of providers that bill that dental/procedural code.

There are a few notable statistical signals in the code-level distribution. 11042 (debridement) is labeled "notably above typical state volume" and ranks #11 of 108 (91st percentile), identifying a specific surgical/wound‑care service line that is unusually prominent for this provider. At the same time, several very high-count items like J3490 (53.5K claims, $962.4K; 95th percentile) and 36415 (65.7K claims, $328.7K; 93rd percentile) are described as "typical, unremarkable volume," which suggests large claim counts that are nonetheless common among peers for those general supply/drug and phlebotomy codes.

Operational tenure is long enough to establish stable patterns: the NPI was enumerated 2006-06-09 (~20 years ago), so the provider has an extended billing history in the dataset. That longevity, combined with concentrated Medicaid revenue and recurring high-volume ED and ancillary codes, supports interpreting these patterns as enduring service-line characteristics rather than short-term anomalies.

For payer strategy and network analysis, the data indicate this hospital should be treated as a Medicaid-centric acute care facility with dominant ED-driven revenue and a noteworthy hospital-based dental/procedural line (41899). Because Medicare billing is absent in the file, any negotiations, risk adjustments, or utilization-management strategies should focus primarily on Medicaid reimbursement dynamics, ED utilization patterns (9928x series), and the specific ancillary services that drive downstream revenue (imaging, infusion, debridement).

Medicaid: Complete Services Breakdown

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

268 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.	31,850	$240	$7.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,500	$2,840	$7.1M
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.	19,660	$350	$6.9M
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.	11,530	$390	$4.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	18,170	$90	$1.6M
G0378	Hospital observation service, per hour	7,730	$190	$1.5M
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.	6,890	$210	$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.	8,030	$150	$1.2M
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.	5,300	$230	$1.2M
J3490	Unclassified drugs	53,470	$20	$962.4K

Showing 1–10 of 268

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

St Elizabeth Medical Center, Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

268 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	297	310	830	$120	$3.7M
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.	77	280	7,150	$150	$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.	65	240	4,710	$150	$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.	38	280	5,700	$120	$2M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	8	40	740	$1,170	$1.7M
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.	49	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	22	90	2,770	$190	$1.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	44	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	38	40	550	$910	$1.1M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	108	170	2,610	$250	$1M

Showing 1–10 of 268

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Elizabeth Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$41.7K	$188.3M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$65.5M
St Elizabeth Medical Center, Inc	KY	Critical Access Hospital	$0	$35.4M
St Elizabeth Medical Center, Inc	IN	General Acute Care Hospital	$0	$4.6M
St Elizabeth Medical Center, Inc	KY	Physician Assistant	$0	$3.8M
St Elizabeth Medical Center, Inc	KY	Community Based Hospice Care Agency	$0	$3M
Peter Fried	OH	Radiation Oncology Physician	$904.7K	$0
Shoaib Ahmad	OK	Pulmonary Disease Physician	$276.1K	$0
William Willmott	KY	Sleep Medicine (Internal Medicine) Physician	$264.9K	$0
Mohamad Sinno	KY	Clinical Cardiac Electrophysiology Physician	$246.6K	$0

Nearby Providers

Other providers in the same ZIP code as St Elizabeth Medical Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Active Day Ky, Inc.	KY	Adult Day Care Clinic/Center	$0	$5.4M
Robert Pettit	KY	Orthopaedic Surgery Physician	$100.5K	$0
Megan Andrasik	KY	Speech-Language Pathologist	$60.3K	$0
Todd Kirchhoff	KY	Otolaryngology Physician	$47.4K	$0
Bryan Krol	KY	Otolaryngology Physician	$43.2K	$0
Maria Pavlou	KY	Geriatric Medicine (Internal Medicine) Physician	$40.7K	$0
Perry Poteet	KY	Otolaryngology Physician	$39.5K	$0
Krista Sheets	KY	Nurse Practitioner	$26.6K	$0
Tracy Stephens	KY	Nurse Practitioner	$16.8K	$0
Lindsay Flaherty	KY	Audiologist	$6.6K	$0

St Elizabeth Medical Center, 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