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.

Memorial Hospital, Inc. (NPI 1811922347)

Key Findings

Field	Value
Entity Type	Organization
Organization	Memorial Hospital, Inc.
Address	210 Marie Langdon Dr
City	Manchester
State	KY
ZIP	40962
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$46.8M
Medicare	$0

MEMORIAL HOSPITAL, INC. appears to operate effectively as a Medicaid-focused facility: there is no Medicare billing on file while total Medicaid revenue is $46.8M, signalling heavy dependence on state reimbursement for overall volume and revenue. This single‑payer concentration means changes to Medicaid policy or rates would likely have outsized impact on the hospital's topline.

The facility has a long tenure in the market, with an NPI enumerated 2006-07-12 (~20 years ago), consistent with an established rural acute care presence rather than a recent entrant. That longevity aligns with the broad mix of emergency, imaging, rehabilitation, and lab services reported.

Revenue is concentrated in a small set of high-impact codes: the Top 3 Medicaid codes (74177, 99284, 99283) account for 32.8% of the provider's total Medicaid revenue. Individually, 74177 generated $3.8M (11.3%), 99284 generated $3.6M (10.9%), and 99283 generated $3.5M (10.6%), indicating a meaningful share of revenue comes from a handful of imaging and ED evaluation codes.

Emergency department care is a principal service-line, with very large claim volumes reported for ED E/M codes: 99284 (22.4K claims, $3.6M revenue), 99283 (28.2K claims, $3.5M revenue), 99285 (18.9K claims, $2.7M revenue) and 99282 (5.4K claims, $437.4K revenue). State percentile ranks for these ED codes (e.g., 99283 at the 84th percentile, 99284 at the 77th percentile, 99285 at the 82th percentile) position the hospital as an above‑typical regional ED volume provider but not a statewide dominant outlier on these codes.

Rehabilitation and physical therapy services are an unusually large and distinctive component of Medicaid billing for this hospital: 97140 ranks #1 of 455 providers in-state (100th percentile), 97035 ranks #1 of 115 (100th percentile), 97010 ranks #1 of 165 (100th percentile), and 97110 ranks #8 of 776 (99th percentile) with $1.7M revenue. These labels (extreme outlier / far above typical state volume) point to a major in‑house PT program that is far larger than typical for Kentucky peers, and represents an important non‑ED revenue stream.

Advanced imaging and diagnostics also drive material Medicaid revenue: CT abdomen/pelvis with contrast 74177 ($3.8M, 11.3%; rank #68/177, 62th percentile), CT abdomen/pelvis without contrast 74176 ($3.1M, 9.3%; rank #64/165, 62th percentile), and head CT 70450 ($1.6M, 4.9%; rank #75/183, 59th percentile) each contribute multimillion-dollar lines. These figures, combined with substantial ultrasound (76705 $511.6K) and cardiac imaging (93306 $550.5K, 78452 $573.9K), show a broad diagnostic imaging footprint supporting both ED and inpatient workflows.

Laboratory and respiratory testing form a visible ancillary business line: PLA codes 0202U ($1.8M, 5.3%; rank #8/27, 73th percentile) and 0225U ($1.2M, 3.6%; rank #1/4, 100th percentile) plus high volumes of molecular COVID/respiratory tests (U0003 10.4K claims, $724.5K; 87636 8.1K claims, $747.2K) indicate on-site or closely affiliated testing capacity that augmented Medicaid revenue during respiratory testing demand. These lab codes are notable contributors to non-procedural revenue.

The hospital also reports significant ED-related supportive services such as IV infusion/administration (96361: 22.5K claims, $944.8K) and hospital observation hours (G0378: 6.7K claims, $666.2K), as well as post‑administration infusion codes (96375: 11K claims, $516.1K). Together these items underline a care model that couples high ED throughput with observation, infusion, and ancillary services that drive incremental Medicaid payments.

Medicaid: Complete Services Breakdown

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

288 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,540	$1,060	$3.8M
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.	22,390	$160	$3.6M
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.	28,250	$120	$3.5M
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.	3,400	$910	$3.1M
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.	18,900	$140	$2.7M
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…	4,430	$400	$1.8M
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…	45,230	$40	$1.7M
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.	3,940	$410	$1.6M
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	39,120	$30	$1.3M
0225U	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 0225U for the…	3,040	$390	$1.2M

Showing 1–10 of 288

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

Memorial Hospital, Inc. — 5 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

288 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.	54	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.	65	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.	43	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.	47	280	5,700	$120	$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.	68	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	24	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…	8	30	2,320	$290	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	29	80	7,740	$30	$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.	64	170	2,610	$250	$1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	30	110	8,390	$50	$749.1K

Showing 1–10 of 288

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital Inc.	KY	Rural Health Clinic/Center	$0	$12.4M
Mathew Joseph	IL	Dermatology Physician	$279.5K	$0
Mitul Kanzaria	WA	Interventional Cardiology Physician	$210.4K	$0
Ashwini Anand	KY	Cardiovascular Disease Physician	$112.9K	$5.6K
Junaid Malik	FL	Pulmonary Disease Physician	$109.5K	$0
Ray Hays	KY	Hospitalist Physician	$42.1K	$0
Gregory Wilkens	KY	Surgery Physician	$20.5K	$0
Andrew Vaughn	TX	Otolaryngology Physician	$2.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clay Community Foundations, LLC	KY	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$7.4M
Mountain Family Practice Clinic Of Manchester Inc	KY	Rural Health Clinic/Center	$0	$4.6M
Air Evac Ems Inc	KY	Air Ambulance	$566.7K	$3.6M
Family Health Care Associates	KY	Rural Health Clinic/Center	$0	$4.1M
Cumberland Valley District Health Department	KY	Home Health Agency	$0	$2.8M
Clay County Fiscal Court	KY	Land Ambulance	$399.1K	$1.6M
Keerthana Karumbaiah	KY	Cardiovascular Disease Physician	$432.3K	$0

Memorial Hospital, 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