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.

Sentara Rmh Medical Center (NPI 1780694372)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sentara Rmh Medical Center
Address	2010 Health Campus Dr
City	Harrisonburg
State	VA
ZIP	22801
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$52.9M
Medicare	$0

This provider effectively operates on a single major public payer: there is no Medicare billing on file while Medicaid revenue totals $52.9M, so the observable billing footprint is dominated by Medicaid-funded care. That concentration in a single payer should shape how analysts think about reimbursement risk and contract negotiations, because changes in Medicaid policy or managed-care arrangements will disproportionately affect overall revenue.

Revenue is heavily concentrated in a few service lines: the precomputed top 3 Medicaid codes by revenue account for 44.7% of this provider's total Medicaid revenue. Those top three codes are 99283 ($8.5M, 20.5%), 99284 ($5.8M, 13.8%), and 96361 ($4.3M, 10.4%), indicating a narrow set of high-value billings that drive nearly half of Medicaid receipts.

The code mix shows a high-volume emergency department operation: ED E/M codes 99283 ($8.5M, 20.5%), 99284 ($5.8M, 13.8%), 99285 ($3.3M, 8.0%), and 99282 ($2.2M, 5.2%) together represent the largest single class of Medicaid revenue. These figures and the presence of G0378 (hospital observation service, $928.4K, 2.2%) signal substantial ED throughput across a broad acuity range, from straightforward to high–medical decision-making visits.

Infusion and dehydration treatments are another material service line: 96361 ($4.3M, 10.4%) is among the top three revenue drivers, and related infusion codes 96365 ($446.4K, 1.1%), 96366 ($551.8K, 1.3%), and 96360 ($531.8K, 1.3%) add further volume. This pattern points to frequent use of IV fluid and medication infusion for Medicaid patients, consistent with ED-driven admissions or short-stay treatment pathways.

The provider offers broad diagnostic and procedural capacity consistent with a full-service acute-care hospital: CT and MRI codes such as 74177 ($1.8M, 4.4%), 70450 ($1.5M, 3.7%), 74176 ($698.6K, 1.7%), 71275 ($667.1K, 1.6%), and 70553 ($479.5K, 1.2%), plus endoscopy codes like 43239 ($828.2K, 2.0%) and 45380 ($441.2K, 1.1%), show meaningful imaging and procedural revenue streams beyond the ED. These line items support the interpretation that inpatient, observation, and same-day procedural services are significant parts of the clinical footprint billed to Medicaid.

On competitive standing within Virginia, the provider is a strong regional participant for several Medicaid services: 99283 ranks #29 of 626 providers in-state (96th percentile) and 99284 ranks #42 of 620 (93rd percentile), both indicating volumes well above typical state peers for ED E/M services. Additional procedures where the provider is notably above typical state volume include 97110 (96th percentile), 62323 (97th percentile), 72148 (94th percentile), 99211 (97th percentile), and 11042 (94th percentile), which together suggest leadership in physical therapy, spinal injections, lumbar MRI, clinic visit volume, and wound debridement among Medicaid providers in the state.

The concentration of Medicaid revenue in ED E/M and infusion codes creates both operational leverage and financial sensitivity: with the top three codes accounting for 44.7% of Medicaid revenue, utilization or reimbursement changes for ED visits and IV therapies would have outsized impact on the provider’s Medicaid topline. That concentration presents opportunities to prioritize quality, utilization management, and care-pathway interventions focused on ED flow and infusion practices to stabilize revenue and manage cost.

The provider has an established presence: NPI enumeration on 2006-08-08 (~20 years ago) indicates long-tenure in the market. Coupled with the diversified acute-care code mix (imaging, endoscopy, surgical debridement, rehabilitation, and high ED volume), this tenure supports the interpretation of a stable regional hospital that serves as a major Medicaid-serving acute-care center in its area.

Medicaid: Complete Services Breakdown

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

386 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.	53,340	$160	$8.5M
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.	38,880	$150	$5.8M
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.	18,040	$240	$4.3M
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.	23,550	$140	$3.3M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	1,620	$1,440	$2.3M
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.	14,600	$150	$2.2M
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…	42,130	$50	$2M
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.	9,580	$190	$1.8M
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.	8,940	$170	$1.5M
G0378	Hospital observation service, per hour	4,690	$200	$928.4K

Showing 1–10 of 386

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

Sentara Rmh Medical Center — 4 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

386 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.	19	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	15	70	3,200	$110	$2.8M
H0035	Mental health partial hospitalization, treatment, less than 24 hours	144	150	5,420	$110	$1.9M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	7	30	600	$1,370	$1.7M
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.	41	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.	29	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.	23	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	33	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.	42	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.	34	180	2,950	$140	$783.2K

Showing 1–10 of 386

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rmh Medical Group LLC	VA	General Practice Physician	$0	$9.8M
Daniel Elbogdadi	VA	Rheumatology Physician	$757K	$0
Christopher Dipasquale	VA	Orthopaedic Surgery Physician	$148.3K	$0
Yasir Akhtar	TN	Interventional Cardiology Physician	$142K	$0
Dawn Alexander	VA	Family Medicine Physician	$126.1K	$0
Aklilu Degene	VA	Pulmonary Disease Physician	$114.1K	$0
Gregory Jesteadt	VA	Family Medicine Physician	$104.3K	$0
Marcus Morra	VA	Urology Physician	$101.9K	$0
Dayuan Li	MN	Cardiovascular Disease Physician	$78.7K	$0
Tracey Robinson	VA	Rheumatology Physician	$70.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Continuing Care Home Health Services Inc	VA	Home Health Agency	$0	$15.3M
Metro Treatment Of Virginia LP	VA	Methadone Clinic	$122.8K	$7.8M
Harrisonburg Community Health Center	VA	Federally Qualified Health Center (FQHC)	$0	$7.7M
Priority Patient Transport Inc	VA	Ambulance	$789.8K	$5.2M
Integrity Home Care LLC	VA	In Home Supportive Care Agency	$0	$5.7M
Christopher Eller	VA	Ophthalmology Physician	$1.7M	$0
Harrisonburg Rescue Squad Incorporated	VA	Ambulance	$542.5K	$1M
Rockingham Eye Surgery Center, LLC	VA	Ambulatory Surgical Clinic/Center	$1.5M	$0
Daryl Kurz	VA	Ophthalmology Physician	$1.1M	$0
Kenlyn Miller	VA	Ophthalmology Physician	$631.8K	$0

Sentara Rmh Medical Center — 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