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

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

Medical University Of Ohio At Toledo (NPI 1811971302)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medical University Of Ohio At Toledo
Address	3000 Arlington Ave
City	Toledo
State	OH
ZIP	43614
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 30, 2005

Payer Source	Total Paid
Medicaid	$50.7M
Medicare	$0

This provider has no Medicare billing on file and is effectively single‑payer in the public programs reported here, with Total Medicaid revenue of $50.7M and Medicare listed as "none". That payer mix implies Medicaid is the primary public revenue source for the organization rather than a complementary stream to Medicare.

Revenue is highly concentrated in a small set of outpatient and emergency codes: the precomputed top‑3 Medicaid codes account for 57.2% of the provider's total Medicaid revenue, with G0463 alone contributing 38.1% ($15.5M). This concentration signals that a few high‑volume outpatient visit codes dominate the facility's Medicaid receipts.

The code mix points to large hospital outpatient and emergency operations: G0463 (161.3K claims, $96 avg paid/claim) is the single largest driver, and ED E/M codes 99284 (38.2K claims, $4.7M, 11.5%), 99283 (25.2K claims, $2.9M, 7.0%), and 99285 (18.1K claims, $2.4M, 6.0%) are also major contributors. Together these lines indicate heavy throughput in outpatient clinic visits and emergency department evaluation and management rather than reliance on inpatient DRG billing in the observed public data.

Competitive standing by code is mixed but generally suggests strong statewide presence for several outpatient services: G0463 ranks #11 of 151 in‑state (93th percentile; typical, unremarkable volume for this code) while 99213 ranks #273 of 5077 (95th percentile; typical, unremarkable volume for this code), showing above‑median placement among peers for office/outpatient E/M activity. At the same time many imaging and procedure codes (for example 74177, 70450, 43239) fall around mid‑percentiles, indicating those ancillary services are present at typical state volumes.

Certain service lines are notable outliers or overindexes relative to state patterns: 97110 (24.6K claims, $1.5M) ranks #33 of 841 (96th percentile; notably above typical state volume), which indicates an unusually large physical therapy/therapeutic exercise program for a hospital in this market. Most other high‑revenue codes are annotated as "typical, unremarkable volume," so PT appears to be a distinct above‑typical service offering relative to peers.

Ancillary, observation, and infusion services are meaningful parts of the Medicaid revenue mix: G0378 observation services (10.1K claims, $515.8K), infusion codes 96365/96361/96366 (combined presence across multiple entries totaling several thousand claims) and lab/diagnostic entries like 80053 (41.6K claims, $457.9K) show the provider performs sustained outpatient monitoring, IV therapies, and high volumes of basic lab work. These items support the profile of a hospital with substantial outpatient treatment, observation, and procedural throughput.

Behavioral health and COVID testing appear in the top code list at material but smaller scales: 90837 psychotherapy (8.8K claims, $820.4K) and U0004 COVID testing (2.9K claims, $449.4K) indicate the facility provides psychiatric/therapy services and high‑throughput COVID diagnostics within its outpatient mix. Both codes are in typical percentile ranges for the state, suggesting these are established parts of the outpatient portfolio rather than outliers.

The provider has long tenure in the NPI registry (NPI enumerated 2005-11-30, ~21 years ago), which combined with the concentrated outpatient/ED billing profile implies an established acute care hospital with sustained outpatient and emergency operations in the Toledo market. This longevity supports interpreting the observed Medicaid patterns as structural operational focus rather than transient reporting fluctuations.

Medicaid: Complete Services Breakdown

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

507 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	161,310	$100	$15.5M
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.	38,210	$120	$4.7M
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…	26,960	$120	$3.1M
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.	25,240	$110	$2.9M
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.	18,130	$130	$2.4M
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.	6,300	$270	$1.7M
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…	24,620	$60	$1.5M
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…	9,360	$120	$1.1M
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.	3,520	$250	$882.3K
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…	8,820	$90	$820.4K

Showing 1–10 of 507

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Medical University Of Ohio At Toledo — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

507 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	11	150	4,030	$100	$5.9M
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.	68	170	4,660	$300	$2.6M
H0015	Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including…	238	610	1,350	$150	$1.9M
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.	112	480	4,510	$90	$1.8M
H2020	Therapeutic behavioral services, per diem	184	310	1,190	$150	$1.5M
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.	85	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.	101	580	510	$100	$1.3M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	140	140	1,130	$90	$1.1M
J0585	Injection, onabotulinumtoxina, 1 unit	57	60	250	$730	$707.7K
H0036	Community psychiatric supportive treatment, face-to-face, per 15 minutes	232	740	480	$60	$669.5K

Showing 1–10 of 507

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danyell Johnson	OH	Adult Health Nurse Practitioner	$61K	$0
Yaseen S Y Alastal	OH	Gastroenterology Physician	$48.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Toledo Physicians LLC	OH	Internal Medicine Physician	$0	$17.8M
Timothy Kasunic	OH	Hematology & Oncology Physician	$2M	$0
Shaili Desai	OH	Hematology & Oncology Physician	$1.2M	$0
Mohammad Rashid	OH	Hematology & Oncology Physician	$565.7K	$0
Satheesh Ramineni	OH	Adult Reconstructive Orthopaedic Surgery Physician	$314.9K	$0
Ellis Sampram	OH	General Practice Physician	$269.9K	$0
Raja Hanif	OH	Family Medicine Physician	$220.6K	$0
Charu Trivedi	OH	Hematology & Oncology Physician	$218.1K	$0
Mohammad Abdulrasool	OH	Family Medicine Physician	$179.7K	$0
Kunal Yadav	OH	Transplant Surgery Physician	$172.2K	$0

Medical University Of Ohio At Toledo — 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