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

Why is the Medicaid comparison limited to New York 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. New York (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.

St Elizabeth Medical Center (NPI 1821093402)

St Elizabeth Medical Center is a general acute care hospital provider located in Utica, New York. This profile covers 0 Medicare and 350 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	St Elizabeth Medical Center
Address	2209 Genesee St
City	Utica
State	NY
ZIP	13501
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 20, 2005

Payer Source	Total Paid
Medicaid	$27.6M
Medicare	$0

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

350 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	13,890	$190	$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.	13,420	$150	$2M
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.	12,440	$160	$2M
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…	53,010	$30	$1.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16,700	$70	$1.2M
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.	2,930	$340	$981.5K
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.	5,650	$160	$920.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	56,020	$20	$840.3K
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.	2,800	$290	$808.9K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	4,910	$130	$657.3K

Showing 1–10 of 350

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New York Distribution

St Elizabeth Medical Center — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New York

Full comparison — all codes billed, vs. New York median

350 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	166	340	1,090	$70	$1.4M
G0378	Hospital observation service, per hour	86	130	1,270	$560	$1.2M
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.	70	210	2,850	$180	$1.1M
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	691	1,510	1,010	$110	$1.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	34	180	3,200	$90	$1M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	888	2,200	1,010	$130	$892.2K
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.	154	1,420	90	$130	$715.2K
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.	126	450	370	$170	$674.1K
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.	160	2,210	80	$130	$473K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	34	110	690	$50	$442K

Showing 1–10 of 350

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Berg	NY	Cardiovascular Disease Physician	$472.1K	$23.3K
Prabhat Varma	NY	Interventional Cardiology Physician	$369.1K	$37.7K
Ashok Patel	NY	Interventional Cardiology Physician	$354.2K	$42.6K
Thor Markwood	NY	Clinical Cardiac Electrophysiology Physician	$304.1K	$22.4K
Faisal Saiful	OR	Interventional Cardiology Physician	$168.9K	$13.4K
Samatha Kadiyala	TX	Obstetrics & Gynecology Physician	$92.6K	$0
Chanderdeep Singh	NY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$91.3K	$0
Edward Pieper	NY	Certified Registered Nurse Anesthetist	$5.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Resource Center For Independent Living	NY	Home Health Agency	$0	$163M
Cnyhhn Inc	NY	Case Management Agency	$0	$76M
Kids Oneida, Inc.	NY	Community/Behavioral Health Agency	$0	$25.2M
Utica Ambulance Service, Inc.	NY	Land Ambulance	$1M	$5.6M
Syed Zaman	NY	Anatomic Pathology & Clinical Pathology Physician	$1.5M	$180
Michael Sassower	NY	Interventional Cardiology Physician	$408.1K	$40.8K
Randy Niblett	NY	Diagnostic Radiology Physician	$90.1K	$260
Nicholas Grillo	NY	Emergency Medicine Physician	$58.1K	$0
Raphael Alcuri	NY	Diagnostic Radiology Physician	$44.4K	$1.6K
Priya Mathew	NY	Registered Dietitian	$20.4K	$0

St Elizabeth Medical Center — Billing Profile & Reimbursement Data

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St Elizabeth Medical Center — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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