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.

Ashland Hospital Corporation (NPI 1851346720)

Field	Value
Entity Type	Organization
Organization	Ashland Hospital Corporation
Address	2201 Lexington Ave
City	Ashland
State	KY
ZIP	41101
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$222.9M
Medicare	$0

Key Findings

ASLHAND HOSPITAL CORPORATION is effectively a Medicaid-centric provider: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $222.9M, indicating the facility’s financial footprint in public payers is driven almost entirely by Medicaid. This makes the organization functionally single-payer at the claims/revenue level for the datasets provided.

Revenue concentration is high across a small set of outpatient codes: the precomputed top 3 Medicaid codes (99213, 99214, U0003) account for 41.8% of the provider’s total Medicaid revenue. Individually those codes generate $24.8M (99213), $18M (99214), and $10.5M (U0003), showing a heavy dependence on a mix of routine E/M visits and high-volume infectious-agent testing.

The code mix signals a large outpatient and clinic footprint: 99213 (800.7K claims, $24.8M) and 99214 (499.5K claims, $18M), together with G0463 (358.8K claims, $5.7M), point to very high-volume established-patient office and hospital outpatient clinic activity. These volumes and revenues are consistent with an operation that funnels substantial ambulatory care through clinic or hospital outpatient settings rather than relying on inpatient or Medicare outpatient billing.

The provider also shows meaningful emergency department and observation activity consistent with an acute care hospital: ED E/M codes 99284 ($9.5M), 99283 ($7.5M), and 99285 ($6.2M) appear in the top revenue list, and G0378 (hospital observation service, $2.2M) is present. These entries indicate routine emergency and observation throughput in addition to the high ambulatory visit volumes.

ASHLAND is a major regional testing center for COVID-era molecular testing: U0003 (152.8K claims, $10.5M, ranks #2 of 106 in-state, 99th percentile; extreme outlier language) and U0005 (118.7K claims, $2.1M, ranks #3 of 70 in-state, 97th percentile) together demonstrate unusually large SARS‑CoV‑2 testing throughput relative to peers. This testing concentration amplifies the provider’s Medicaid revenue footprint through high claim volumes.

The hospital supports a broad procedural and imaging portfolio beyond primary care: high-revenue procedural and imaging codes such as 43239 ($3.8M, ranks #1 of 174, 100th percentile), 47562 ($2.7M, ranks #2 of 37, 97th percentile), 93458 ($2.7M, ranks #1 of 56, 100th percentile), 74177 ($4.1M) and 78452 ($4.0M) indicate capability in endoscopy, laparoscopy, coronary imaging, CT, and nuclear cardiac studies. Together these suggest ASHLAND operates significant inpatient/outpatient procedural capacity alongside its outpatient clinic volume.

Competitive standing in-state is dominant for multiple high-volume codes: 99213 and 99214 rank #2 of 3339 and #2 of 2462 respectively and are labeled extreme outliers at the 100th percentile, while procedure codes like 43239 and 93458 rank #1 of their peer groups at the 100th percentile. Multiple diagnostic lab and imaging codes (e.g., 80053 rank #2 of 195, 99th percentile; 71046 rank #4 of 325, 99th percentile) further position ASHLAND as a major Medicaid service provider in Kentucky across outpatient, diagnostic, and certain specialty procedures.

The provider’s NPI tenure (enumerated 2006-05-22, ~20 years ago) indicates a long-standing presence in the market; combined with the concentrated Medicaid revenue ($222.9M) and repeated high-percentile rankings, this suggests a mature regional provider with entrenched Medicaid service volume and specialty capabilities.

Medicaid: Complete Services Breakdown

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

794 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	800,710	$30	$24.8M
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…	499,500	$40	$18M
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…	152,840	$70	$10.5M
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.	49,200	$190	$9.5M
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.	61,570	$120	$7.5M
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.	35,590	$170	$6.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	358,800	$20	$5.7M
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.	9,930	$410	$4.1M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	9,760	$410	$4M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	10,380	$370	$3.8M

Showing 1–10 of 794

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

Ashland Hospital Corporation — 16 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

794 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	8	10	810	$7,760	$8.7M
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.	22	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.	24	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.	14	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.	41	40	740	$1,170	$1.7M
S9128	Speech therapy, in the home, per diem	13	30	8,300	$70	$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.	29	180	1,870	$280	$1.5M
G0378	Hospital observation service, per hour	11	90	2,770	$190	$1.3M
C1776	Joint device (implantable)	21	20	130	$2,890	$1.1M
S9129	Occupational therapy, in the home, per diem	16	30	7,220	$70	$1.1M

Showing 1–10 of 794

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ashland Hospital Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
King's Daughters Medical Center	MS	General Acute Care Hospital	$0	$32.2M
Kdmc Physician Clinics LLC	MS	Multi-Specialty Clinic/Center	$0	$9.2M
State Of Mississippi - University Of Mississippi Medical Center	MS	Critical Access Hospital	$0	$7.5M
Reuben Stone	MS	Cardiovascular Disease Physician	$1.1M	$0
William Winn	MN	Diagnostic Radiology Physician	$997.1K	$0
Donny Stokes	MS	Cardiovascular Disease Physician	$881.8K	$0
Brett Bennett	MS	Interventional Cardiology Physician	$779K	$0
Robert Fried	KY	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$719.4K	$0
James Bennett	MS	Interventional Cardiology Physician	$661.1K	$0
Terry Justice	KY	Radiation Oncology Physician	$597.6K	$0

Nearby Providers

Other providers in the same ZIP code as Ashland Hospital Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pathways, Inc.	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$95.4M
Pathways Inc	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$82.2M
A Brighter Future	KY	Community/Behavioral Health Agency	$0	$39.8M
A Center 4 Change	KY	Counseling Psychologist	$0	$22M
Fivco Add Cdo As Fiscal Agent	KY	Supports Brokerage Agency	$0	$21M
Our Lady Of Bellefonte Hospital Inc	KY	General Acute Care Hospital	$0	$12.1M
Advocate Medical Services, LLC	KY	Durable Medical Equipment & Medical Supplies	$0	$10.6M
Ultimate Care Behavioral Health Services	KY	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.6M
Wecare Medical, LLC	KY	Oxygen Equipment & Supplies (DME)	$0	$9.9M
Nancy Mussetter	KY	Dentist	$0	$8M

Ashland Hospital Corporation — 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