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NPI 1801840434 · Cincinnati, OH · Family Medicine Physician
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University Of Cincinnati Physicians Company, LLC is a family medicine physician provider located in Cincinnati, Ohio. This profile covers 0 Medicare and 381 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | University Of Cincinnati Physicians Company, LLC |
| Address | 3188 Bellevue Ave |
| City | Cincinnati |
| State | OH |
| ZIP | 45219 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | May 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $65.2M |
| Medicare | $0 |
This provider has no Medicare billing on file and reports Total Medicaid revenue of $65.2M, making its billed population effectively concentrated in Medicaid rather than split across Medicare and Medicaid. The absence of Medicare activity indicates the provider’s operational footprint or payer relationships are currently centered on state Medicaid reimbursements rather than federal Medicare volume.
Revenue is highly concentrated: the precomputed top 3 Medicaid codes (99214, 99213, 99284) account for 48.4% of the provider’s total Medicaid revenue. Those three codes individually generate $9.5M (99214 — 18.1%), $8.6M (99213 — 16.4%), and $7.3M (99284 — 13.9%), indicating a small number of services drive nearly half of Medicaid receipts.
The code mix indicates a hybrid hospital-and-outpatient business model rather than a narrow primary-care practice. High-volume office E/M codes (99214, 99213), coupled with substantial emergency department codes (99284, 99285, 99283), inpatient subsequent-care codes (99232, 99233) and critical care (99291), plus significant obstetrics, imaging, pathology and cardiac procedure billing, point to an organization that bills for ambulatory primary care visits as well as intensive hospital-based, imaging, and specialty services.
Competitive standing in-state is strong and often extreme: 99214 ranks #12 of 4514 providers in-state (100th percentile; extreme outlier) and 99213 ranks #13 of 5077 (100th percentile; extreme outlier), while procedure-level leadership includes 59409 at #1 of 50 (100th percentile; extreme outlier) and 59025 at #1 of 204 (100th percentile; extreme outlier). Multiple other codes show top-tier statewide rank and percentiles (for example, 99291 #4 of 262, 99th percentile; extreme outlier and 93306 #4 of 328, 99th percentile; extreme outlier), characterizing the provider as a dominant Medicaid billing entity across several service lines within Ohio.
The ambulatory E/M business is volume-driven with modest per-claim payments: 99214 shows 270.5K claims at $35 avg paid/claim for $9.5M revenue and 99213 shows 343.7K claims at $25 avg paid/claim for $8.6M revenue. These figures reflect high patient throughput where overall revenue is generated from very large claim counts rather than high unit prices.
Acute and critical-care activity is a material revenue contributor to the Medicaid mix. Emergency department codes 99284 (143.2K claims, $51 avg paid/claim, $7.3M) and 99285 (91K claims, $69 avg paid/claim, $6.3M) together with inpatient subsequent-care codes 99232 (112.4K claims, $23 avg paid/claim, $2.6M) and 99233 (51.2K claims, $32 avg paid/claim, $1.6M) and critical care 99291 (29.8K claims, $64 avg paid/claim, $1.9M) indicate substantial hospital-based acute care volumes billed to Medicaid.
The provider captures a broad set of ancillary services beyond E/M and ED care, including pathology (88305 $1.6M; 88307 $476.8K), imaging (70450 $1.2M; 74177 $1.2M; 70553 $669.2K), cardiac testing and echo (93010 $739.6K; 93306 $1.1M), EEG review (95720 $657.8K) and ESRD monthly management (90960 $606.2K). This breadth supports the interpretation that the billing entity operates across multiple clinical and diagnostic lines, increasing its Medicaid revenue diversity even as top E/M and ED codes remain dominant.
The provider’s NPI was enumerated on 2006-05-19 (~20 years ago), indicating long tenure in the billing system; combined with the concentrated Medicaid revenue profile and extensive in-state rankings, this suggests an established, high-volume Medicaid billing operation with entrenched state-level market presence.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
381 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 270,490 | $40 | $9.5M |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 343,690 | $30 | $8.6M |
| 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. | 143,230 | $50 | $7.3M |
| 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. | 90,970 | $70 | $6.3M |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 112,400 | $20 | $2.6M |
| 99291 | Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is… | 29,820 | $60 | $1.9M |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 51,240 | $30 | $1.6M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 35,760 | $50 | $1.6M |
| 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. | 32,590 | $40 | $1.2M |
| 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. | 46,370 | $30 | $1.2M |
Showing 1–10 of 381
How this provider's Medicaid billing volume and revenue compare to other Ohio providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Ohio median
381 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| H0020 | Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) | 99 | 120 | 7,190 | $30 | $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. | 123 | 480 | 4,510 | $90 | $1.8M |
| 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. | 18 | 660 | 460 | $90 | $1.5M |
| 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. | 15 | 580 | 510 | $100 | $1.3M |
| 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. | 9 | 290 | 1,380 | $90 | $635.2K |
| 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. | 10 | 280 | 1,110 | $110 | $605.7K |
| 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. | 136 | 230 | 2,200 | $100 | $530.1K |
| 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. | 173 | 180 | 1,760 | $140 | $494.1K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 554 | 2,640 | 620 | $90 | $408.2K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 12 | 4,510 | 500 | $60 | $377.8K |
Showing 1–10 of 381
Other providers in the same ZIP code as University Of Cincinnati Physicians Company, LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| University Of Cincinnati Medical Center, LLC | OH | General Acute Care Hospital | $0 | $176.6M |
| Christ Hospital | OH | General Acute Care Hospital | $0 | $49.6M |
| University Surgical-dental Associates, LLC | OH | Oral & Maxillofacial Surgery (D.M.D.) | $0 | $8.2M |
| Hsc Surgical Associates Of Cincinnati, LLC | OH | Ambulatory Surgical Clinic/Center | $567.2K | $1.1M |
| Hugh Gloster | OH | MOHS-Micrographic Surgery Physician | $1.1M | $0 |
| Kavita Talati | OH | Gerontology Nurse Practitioner | $673.1K | $0 |
| Greg Mott | OH | Internal Medicine Physician | $417.8K | $0 |
| John Houk | OH | Rheumatology Physician | $386.4K | $0 |
| Edward Schloss | OH | Clinical Cardiac Electrophysiology Physician | $366.8K | $0 |
| Avis Ware | OH | Rheumatology Physician | $297.9K | $0 |
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