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.

Norton Hospitals, Inc (NPI 1891799227)

Field	Value
Entity Type	Organization
Organization	Norton Hospitals, Inc
Address	200 E Chestnut St
City	Louisville
State	KY
ZIP	40202
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 13, 2005

Payer Source	Total Paid
Medicaid	$299.3M
Medicare	$0

Key Findings

This provider effectively operates as a Medicaid-focused institution: there is no Medicare billing on file while total Medicaid revenue is $299.3M, so all reported fee-for-service hospital activity in our dataset comes through Medicaid. The absence of Medicare claims limits any direct comparison of its Medicare market position and suggests payer mix is heavily concentrated toward state Medicaid programs.

Revenue concentration is high in a few procedure types: the top three Medicaid codes (99284, 99283, 74177) account for 37.3% of the provider’s total Medicaid revenue. Individually those codes generated $25.5M (15.4%), $24.8M (15.0%), and $11.5M (6.9%) respectively, indicating a small set of emergency and imaging services drive a large share of dollars.

Operationally the code mix indicates a high-volume emergency and diagnostic imaging center: 99284 and 99283 together represent large ED volumes (82.8K and 90.2K claims) alongside substantial CT activity (74177 with 17.4K claims and $11.5M revenue). Additional ED codes (99285, 99282) and multiple CT/MRI codes (70450, 70551, 70553, 72148, 74176, 71275) show the facility’s workflow centers on acute evaluation, high-throughput imaging, and inpatient-ready diagnostics.

State-level competitive standing is strong across many Medicaid service lines: for ED codes the provider ranks in the top decile in-state (99283 ranks #7 of 284 providers, 98th percentile; 99284 ranks #9 of 282, 97th percentile) and shows extreme volume for some lower-complexity ED visits (99282 ranks #4 of 158 providers, 98th percentile; labeled an extreme outlier). These ranks indicate the provider is a major in-state participant for emergency care and related throughput services.

There are notable high-cost drug and implant revenue streams alongside ED and imaging: J9271 (pembrolizumab) generated $9.5M (5.8% of Medicaid revenue) and ranks #4 of 9 in-state (63th percentile, typical), while implant codes C1776 and C1713 produced $8.2M (5.0%) and $5.9M (3.6%) respectively and rank #4 in their in-state cohorts. This mix signals significant oncology/infusion and procedural implant activity contributing materially to total Medicaid revenue.

Several service lines are statistical outliers or well above typical state volume, suggesting concentrated operational strengths: the multiplex respiratory test 87637 is an extreme outlier and ranks #1 of 48 providers in-state (100th percentile), J3490 is an extreme outlier (99.7K claims; ranks #3 of 104, 98th percentile), and 99282 is flagged as an extreme outlier (36.8K claims; ranks #4 of 158, 98th percentile). In addition, multiple imaging and infusion codes are described as 'notably above typical' (e.g., 70450, 70551, 70553, 72148, 96374), reinforcing the provider’s outsized role in those services.

Volume-driven, low-unit-price services are a major contributor to Medicaid revenue: codes with very high claim counts and modest average paid/claim—such as J3490 (99.7K claims, $55 avg), 96374 (54.9K claims, $45 avg), and 93005 (46.1K claims, $51 avg)—collectively produce multi-million-dollar revenue lines. This pattern indicates the provider captures large throughput-based revenue in addition to its higher-unit, lower-frequency items like biologic drugs and implants.

The provider has long tenure in the dataset, with NPI enumeration dated 2005-06-13 (~21 years ago), which aligns with the scale and breadth of Medicaid activity observed across emergency services, imaging, infusion, and implant procedures. Historical presence at this scale supports interpretation of the provider as an established regional acute-care hospital with entrenched Medicaid service volumes.

Medicaid: Complete Services Breakdown

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

826 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.	82,800	$310	$25.5M
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.	90,210	$280	$24.8M
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.	17,430	$660	$11.5M
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.	33,980	$290	$9.8M
J9271	Injection, pembrolizumab, 1 mg	1,060	$9,040	$9.5M
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.	36,820	$240	$8.8M
C1776	Joint device (implantable)	880	$9,360	$8.2M
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.	19,610	$330	$6.4M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	11,030	$560	$6.2M
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	3,890	$1,530	$5.9M

Showing 1–10 of 826

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

Norton Hospitals, Inc — 11 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

826 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	4	10	810	$7,760	$8.7M
J9299	Injection, nivolumab, 1 mg	4	10	540	$6,390	$4M
97535	A healthcare provider is required to give proper instruction to a person especially in cases of recovery from acute disease.	74	310	830	$120	$3.7M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	3	10	4,350	$560	$3.3M
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.	9	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.	25	240	4,710	$150	$2.6M
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	10	140	$3,650	$2.5M
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.	7	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.	24	40	740	$1,170	$1.7M
J3380	Injection, vedolizumab, intravenous, 1 mg	3	10	110	$5,930	$1.6M

Showing 1–10 of 826

Related Providers

Other providers that share a Tax Identification Number (TIN) with Norton Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norton Hospitals Inc	KY	General Acute Care Hospital	$0	$419.8M
Norton Hospitals Inc	KY	Multi-Specialty Clinic/Center	$0	$3.4M
Norton Hospitals Inc	KY	Land Ambulance	$791.2K	$77.1K
Emmanuel Nidhiry	KY	Medical Oncology Physician	$347.6K	$0
Aaron Spalding	KY	Radiation Oncology Physician	$227.5K	$0
Joseph Maly	KY	Hematology & Oncology Physician	$164.3K	$0
Yong Cha	KY	Radiation Oncology Physician	$153.8K	$0
Nadeem Usmani	KY	Pain Medicine (Anesthesiology) Physician	$151.6K	$0
Sarah Parsons	KY	Psychiatry Physician	$151.4K	$0
Basel Altoos	KY	Radiation Oncology Physician	$137.2K	$0

Nearby Providers

Other providers in the same ZIP code as Norton Hospitals, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Uofl Health-louisville Inc	KY	General Acute Care Hospital	$0	$283.3M
University Medical Center, Inc	KY	General Acute Care Hospital	$0	$179.5M
Verralab Ja LLC	KY	Clinical Medical Laboratory	$304.7K	$38.8M
University Medical Associates	KY	Internal Medicine Physician	$0	$17.3M
Ocean Behavioral Healthcare LLC	KY	Clinical Social Worker	$0	$11.9M
University Emergency Medicine Associates P.s.c.	KY	Emergency Medicine Physician	$0	$11.8M
Recovery Chestnut, LLC	KY	Addiction (Substance Use Disorder) Counselor	$0	$10.9M
Green House Recovery And Rehabilitation Center	KY	Multi-Specialty Clinic/Center	$0	$10.6M
University Of Louisville	KY	General Practice Dentistry	$0	$8.3M
Pediatric And Adult Prompt Care LLC	KY	Pediatrics Physician	$0	$6.9M

Norton Hospitals, 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