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.

Kentucky Hospital, LLC (NPI 1811213994)

Key Findings

Field	Value
Entity Type	Organization
Organization	Kentucky Hospital, LLC
Address	175 Hospital Dr
City	Winchester
State	KY
ZIP	40391
Taxonomy	General Acute Care Hospital
NPI Enumerated	April 14, 2010

Payer Source	Total Paid
Medicaid	$83.8M
Medicare	$0

KENTUCKY HOSPITAL, LLC is effectively a Medicaid-centric provider: there is no Medicare billing on file while total Medicaid revenue is $83.8M, indicating the facility’s reported payer mix is dominated by Medicaid receipts rather than Medicare. This profile should be treated as single-payer–dominated for purposes of Medicare/Medicaid comparative analyses because Medicare activity is absent in the record.

Revenue concentration is high among a small set of codes: the precomputed top 3 Medicaid codes by revenue account for 43.5% of this provider’s total Medicaid revenue. The three top revenue drivers are 99284 ($11.8M, 19.2%), 74177 ($7.7M, 12.5%), and 99285 ($7.2M, 11.7%), which together make up the concentrated share of the hospital’s Medicaid receipts.

The code mix points to a high-volume emergency and diagnostic imaging operation: 99284 and 99285 are the first- and third-largest revenue contributors and are emergency department E/M services at moderate and high levels of decision making, while 74177 (CT abdomen and pelvis with contrast) is the second-largest code. This combination of high-revenue ED E/M codes plus advanced CT imaging suggests the hospital is functioning as an acute care center with a busy ED that relies on cross-sectional imaging for case workup.

0202U (BioFire FilmArray RP2.1) is a notable diagnostic outlier in-state: it generated $6.9M and accounts for 11.2% of the provider’s Medicaid revenue, and it ranks #1 of 27 providers in-state at the 100th percentile with a plain-English label of "notably above typical state volume." High volume of this proprietary respiratory panel indicates substantial on-site molecular respiratory testing throughput relative to peers.

Several operational support lines also rank above typical state volume, reinforcing breadth of acute services: 96361 (IV fluids, additional hour) is $901.3K and ranks #6 of 99 (95th percentile; notably above typical state volume), and 80053 (CMP panel) is $921.5K and ranks #14 of 195 (93th percentile; notably above typical state volume). These patterns imply sustained demand for basic lab monitoring and ongoing IV management consistent with ED/observation care.

Competitive standing for the leading ED and imaging codes is generally in the upper state percentiles but described as typical rather than dominant: 99284 ranks #21 of 282 (93th percentile; typical, unremarkable volume), 74177 ranks #21 of 177 (89th percentile; typical, unremarkable volume), and 99285 ranks #37 of 239 (85th percentile; typical, unremarkable volume). In plain terms, the hospital is a solid mid-to-upper-tier Medicaid participant for these high-revenue services statewide, but not an extreme outlier dominating the market.

Service mix beyond ED and CT also reflects standard hospital acute-care throughput: substantial counts and revenue appear in CT head (70450 $2.5M), CT chest CTA (71275 $1.7M), cardiac echo (93306 $1.4M), and observation (G0378 $1.8M), each showing typical in-state rankings. Together these codes support a picture of comprehensive diagnostic, cardiac, and observation capacity aligned with general acute care hospital operations.

The provider has a sustained operational tenure on file: the NPI was enumerated on 2010-04-14 (~16 years ago), indicating more than a decade of presence in the state market. That duration, combined with concentrated Medicaid receipts and consistently above-typical volumes in specific diagnostics and IV/monitoring services, suggests an established acute-care facility with a focus on emergency, imaging, and in-hospital diagnostic throughput.

Medicaid: Complete Services Breakdown

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

391 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	50,140	$240	$11.8M
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.	12,210	$630	$7.7M
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.	22,430	$320	$7.2M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	18,900	$360	$6.9M
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.	37,090	$140	$5.2M
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.	11,190	$220	$2.5M
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.	4,020	$560	$2.2M
G0378	Hospital observation service, per hour	4,580	$400	$1.8M
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	4,280	$410	$1.7M
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	3,890	$380	$1.5M

Showing 1–10 of 391

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

Kentucky Hospital, LLC — 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

391 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.	155	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.	21	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.	37	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.	29	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.	39	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.	21	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	32	90	2,770	$190	$1.3M
0202U	This is a Proprietary Laboratory Analyses (PLA) code, meaning that the code applies to only one unique lab test made by a specific manufacturer or performed by a specific lab. Report 0202U for the…	1	30	2,320	$290	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	62	80	7,740	$30	$1.1M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	22	40	550	$910	$1.1M

Showing 1–10 of 391

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clark Regional Physician Practices, LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$9.4M
Clark Regional Physician Practices LLC	KY	Rural Health Clinic/Center	$0	$3M
Steven Jones	AZ	Diagnostic Radiology Physician	$83.2K	$107.7K
Enio Kuvliev	KY	Internal Medicine Physician	$143K	$0
Freddie Terrell	KY	Urology Physician	$109.4K	$0
Bruce Kostelnik	KY	Emergency Medicine Physician	$87.9K	$0
Yousof Elgaried	KY	Pulmonary Disease Physician	$87.1K	$0
Alexander Landfield	KY	Neurology Physician	$70.8K	$0
Charles Arnold	KY	Family Medicine Physician	$55.3K	$0
Selena Raines	KY	Family Medicine Physician	$37.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky Addiction Centers, LLC	KY	Substance Abuse Rehabilitation Facility	$0	$16.7M
Dungarvin Kentucky, LLC - Winchester	KY	Developmentally Disabled Services Day Training Agency	$0	$13.4M
Caky E Winchester	KY	Case Management Agency	$0	$12.1M
New Day Recovery Center	KY	Substance Abuse Rehabilitation Facility	$0	$10.6M
John I. Gray, Iii, Psc	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$7.1M
Clark Emergency Physicians	KY	Emergency Medicine Physician	$0	$6.7M
Beall Recovery Clinics	KY	Addiction Medicine (Preventive Medicine) Physician	$0	$5M
Kentucky Orthopaedics & Spine PLLC	KY	Orthopaedic Surgery Physician	$0	$4.6M
Timothy Crisp	KY	Pediatric Dentistry	$0	$4.4M
Oral Surgery & Implant Associates	KY	Oral and Maxillofacial Surgery (Dentist)	$0	$3.7M

Kentucky Hospital, LLC — 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