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

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

Sacred Heart Health System, Inc. (NPI 1922032424)

Key Findings

Field	Value
Entity Type	Organization
Organization	Sacred Heart Health System, Inc.
Address	5151 N 9th Ave
City	Pensacola
State	FL
ZIP	32504
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$38.5M
Medicare	$0

SACRED HEART HEALTH SYSTEM, INC. reports no Medicare billing on file and $38.5M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer Medicaid. The absence of any Medicare revenue on file indicates Medicaid dominates reported payer activity for this entity rather than a balanced Medicare/Medicaid mix. Analysts should treat Medicaid trends as the primary driver of observed billing behavior.

Revenue concentration is high: the top 3 Medicaid codes by revenue account for 48.4% of this provider's total Medicaid revenue, driven by emergency department E/M codes 99283 ($7M, 24.9%), 99284 ($4.1M, 14.4%), and 99285 ($2.5M, 9.1%). This concentration shows nearly half of Medicaid dollars are tied to ED visits across low, moderate, and high decision‑making levels, signaling ED activity as the core revenue engine.

The code mix and volumes point to a high‑volume emergency department operation: 99283 has 88.5K claims ($7M) and ranks #26 of 701 providers in-state (96th percentile) and is described as notably above typical state volume; 99284 has 43.6K claims ($4.1M) and 99285 has 29.2K claims ($2.5M), both ranking in the 93th percentile bracket. Together these figures indicate consistent throughput across acuity levels in urgent and emergent care rather than a narrow procedural specialty.

Ancillary acute‑care services are substantial and aligned with ED/inpatient throughput: high volumes of specimen and lab work (85025: 118.6K claims, $355.8K; 81001: 52.6K claims, $578.5K), phlebotomy (36415: 73.4K claims, $1.2M; ranked in the 99th percentile and noted as notably above typical state volume), and imaging (74177: $487.8K) support a busy diagnostic workflow. The presence of numerous infusion and administration codes (96361: $967.7K; 96375: $649.9K; 96367: $564.8K) further corroborates frequent ED/inpatient medical treatments that rely on IV therapies.

Therapy and rehabilitation services are meaningful revenue contributors: 97530 (23.7K claims, $1M, 3.7%) and 97110 (23.7K claims, $1M, 3.6%) each account for multiple percentage points of Medicaid revenue and rank in higher state percentiles (97530 at the 92th percentile, described as typical; 97110 at the 95th percentile, described as notably above typical). This pattern suggests integrated physical‑therapy or rehab capacity co‑located with acute services, contributing to non‑ED revenue diversification.

Selected codes show area‑level dominance on specific services beyond ED care: 41899 (dental/adjoining alveolar procedures) produced $948.8K (3.4%) and ranks #4 of 41 providers in-state (93th percentile, notably above typical state volume), while 96361 and 96375 infusion codes also rank notably above typical state volume. These high rankings in narrower code buckets indicate the provider is a regional leader for certain procedural services despite being Medicaid‑centric overall.

Other frequently billed ED and related low‑acuity codes appear at typical volumes for the state (for example, 99284 and 99285 are flagged as typical, unremarkable volume despite high absolute counts), indicating that while the provider is a high‑throughput ED overall, some components align with statewide norms. This mix of notable outperformance on specific codes and typical volume on others suggests operational focus areas rather than uniform dominance across all ED services.

The provider’s NPI was enumerated on 2006-07-10 (~20 years ago), indicating long tenure in the market. Coupled with multiple high percentile ranks across key Medicaid codes and concentrated Medicaid revenue, the data portray an established, regionally significant acute care hospital whose public payer exposure and competitive positioning are predominantly defined by Medicaid emergency and associated acute services.

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
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.	88,500	$80	$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.	43,550	$90	$4.1M
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.	29,200	$90	$2.5M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	14,990	$100	$1.5M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	73,370	$20	$1.2M
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	23,710	$40	$1M
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…	23,680	$40	$1M
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.	15,120	$60	$967.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	2,620	$360	$948.8K
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.	9,990	$80	$829.5K

Showing 1–10 of 507

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Sacred Heart Health System, Inc. — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

507 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	26	700	2,400	$80	$1.2M
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.	56	740	2,180	$70	$1.1M
J9271	Injection, pembrolizumab, 1 mg	12	10	630	$1,300	$977.3K
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.	46	660	1,900	$70	$743.6K
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	7	10	1,510	$190	$692.6K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	12	30	310	$720	$616.3K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	23	30	750	$90	$563.1K
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.	44	320	1,970	$90	$463.1K
86003	The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…	6	20	620	$30	$423.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	4	40	400	$460	$395.7K

Showing 1–10 of 507

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Union Associated Physicians Clinic, LLC	IN	Family Medicine Physician	$0	$31.1M
Saint Thomas Rutherford Hospital	TN	General Acute Care Hospital	$0	$16.2M
Aspirus Stevens Point Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$15.6M
Sacred Heart Health System, Inc.	FL	Family Medicine Physician	$0	$12.3M
Ascension Sacred Heart Emerald Coast	FL	General Acute Care Hospital	$0	$11.9M
Aspirus Riverview Hospital & Clinics, Inc.	WI	General Acute Care Hospital	$0	$10.9M
St Vincents Ambulatory Care Inc	FL	Neurological Surgery Physician	$0	$10.4M
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.	WI	General Acute Care Hospital	$0	$10.2M
Saint Thomas River Park Hospital, LLC	TN	General Acute Care Hospital	$0	$8.4M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pensacola Pediatrics PA	FL	Pediatrics Physician	$0	$20.4M
Pediatric Services Of America, LLC	FL	Nursing Care Agency	$0	$14.8M
Renal Care Group Of The Southeast, Inc.	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$14.1M
Augustine Emergency Physicians LLC	FL	Emergency Medicine Physician	$0	$9.6M
Pet LLC	FL	Nuclear Radiology Physician	$2.4M	$118.6K
Christopher Lecroy	FL	Vascular Surgery Physician	$1.1M	$0
Clark Pollitt	FL	Diagnostic Radiology Physician	$1.1M	$0
Aref Rifai	FL	Retina Specialist (Ophthalmology) Physician	$1M	$0
Robert Nusbaum	FL	Diagnostic Radiology Physician	$946.9K	$0
Fresenius Vascular Care Of Pensacola Asc LLC	FL	Ambulatory Surgical Clinic/Center	$793.4K	$141K

Sacred Heart Health System, 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