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

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

Swedishamerican Hospital (NPI 1760542732)

Swedishamerican Hospital is a general acute care hospital provider located in Rockford, Illinois. This profile covers 0 Medicare and 193 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	Swedishamerican Hospital
Address	1401 E State St
City	Rockford
State	IL
ZIP	61104
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 11, 2006

Payer Source	Total Paid
Medicaid	$4.8M
Medicare	$0

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

193 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	29,780	$90	$2.6M
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	2,520	$110	$269.4K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	11,260	$10	$157.6K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	11,200	$10	$156.7K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	1,960	$50	$105.7K
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…	6,630	$10	$92.8K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	14,830	$10	$89K
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.	22,000	$1	$66K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	3,440	$20	$65.4K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	510	$110	$55.9K

Showing 1–10 of 193

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Swedishamerican Hospital — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

193 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	73	280	1,120	$30	$218.9K
87902	The lab analyst performs the technical lab test to analyze the specific genotype by nucleic acid of a specimen containing hepatitis C virus.	3	10	80	$160	$192K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	10	110	150	$40	$184.1K
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…	19	1,220	540	$60	$179.4K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	25	360	600	$30	$165.1K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	25	360	630	$30	$165K
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…	75	110	200	$40	$111.1K
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.	181	350	390	$50	$107.7K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	49	70	370	$20	$104.1K
83013	The lab analyst tests multiple breath samples for the presence of an isotope that indicates the presence of the H. pylori bacteria. This organism can cause irritation and ulcers of the stomach lining.	12	30	80	$40	$103.3K

Showing 1–10 of 193

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bronson Methodist Hospital	MI	Hospitalist Physician	$0	$64.8M
Sara Fleming	IL	Anatomic Pathology & Clinical Pathology Physician	$24.6K	$12.9M
Bronson Battle Creek Hospital	MI	Internal Medicine Physician	$0	$9.8M
Bryan Kim	IL	Retina Specialist (Ophthalmology) Physician	$2.2M	$221.8K
John Lee	NJ	Interventional Cardiology Physician	$1.6M	$0
William Stephan	IL	Interventional Cardiology Physician	$1.4M	$8.4K
Elsayed Mohamed	IL	Interventional Cardiology Physician	$790K	$38.8K
Shiraz Rahim	ID	Diagnostic Radiology Physician	$148.8K	$599.6K
Cash Casey	IL	Clinical Cardiac Electrophysiology Physician	$621.3K	$45.2K
Pratik Parikh	IL	Interventional Cardiology Physician	$589.1K	$58.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
City Of Rockford	IL	Ambulance	$1.3M	$63.7M
Crusaders Central Clinic Association	IL	Federally Qualified Health Center (FQHC)	$0	$38.9M
Rockford Public Schools Dis205	IL	Local Education Agency (LEA)	$0	$13.7M
The Board Of Trustees Of The University Of Illinois	IL	Federally Qualified Health Center (FQHC)	$0	$7.1M
Aunt Martha's Health And Wellness	IL	Federally Qualified Health Center (FQHC)	$0	$2.9M
Wei Gao	IL	General Practice Dentistry	$0	$2.9M
Juliette Strombeck	IL	Family Nurse Practitioner	$183.2K	$621K
Eric Cuasay	IL	Diagnostic Radiology Physician	$81.9K	$425.5K
Anna August	IL	Family Nurse Practitioner	$114.6K	$191.5K
Jeffrey Royce	IL	Family Medicine Physician	$20.6K	$144K

Swedishamerican Hospital — Billing Profile & Reimbursement Data

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Swedishamerican 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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