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

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

Presence Chicago Hospitals Network (NPI 1922177229)

Presence Chicago Hospitals Network is a general acute care hospital provider located in Chicago, Illinois. This profile covers 0 Medicare and 78 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	Presence Chicago Hospitals Network
Address	1127 N Oakley Blvd
City	Chicago
State	IL
ZIP	60622
Taxonomy	General Acute Care Hospital
NPI Enumerated	November 8, 2006

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

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

78 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	32,250	$110	$3.5M
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	3,380	$70	$246.6K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	3,090	$60	$169.7K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1,310	$80	$101.2K
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…	760	$90	$68.4K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	620	$30	$20K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	2,130	$10	$19.2K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	2,290	$10	$16K
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.	3,910	$1	$15.7K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	2,140	$10	$15K

Showing 1–10 of 78

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Presence Chicago Hospitals Network — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

78 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…	152	350	400	$70	$514.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	201	280	1,120	$30	$218.9K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	151	250	450	$40	$185.7K
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…	16	1,220	540	$60	$179.4K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	263	360	600	$30	$165.1K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	258	360	630	$30	$165K
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…	738	1,180	370	$90	$109.7K
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.	212	740	960	$10	$75.9K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	174	530	840	$10	$73.9K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	195	370	560	$10	$60.5K

Showing 1–10 of 78

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Presence Behavioral Health	IL	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$10.3M
Presence Central And Suburban Hospitals Network	IL	General Acute Care Hospital	$0	$4.8M
Lawrence Kaufman	IL	Pediatric Ophthalmology and Strabismus Specialist Physician Physician	$6.3K	$2.8M
Purshotam Sawlani	IL	Cardiovascular Disease Physician	$689.7K	$310.9K
Mustafa Hindi	IL	Emergency Medicine Physician	$107.8K	$744.8K
Katrina Nguyen	IL	Emergency Medicine Physician	$654.1K	$112.5K
William Maloney	WI	Emergency Medicine Physician	$96.4K	$655.9K
Larry Jankelowitz	IL	Pulmonary Disease Physician	$281K	$426.5K
Theresa Gandor	IL	Emergency Medicine Physician	$200K	$489K
Guneesh Saluja	IN	Emergency Medicine Physician	$119K	$494.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Erie Family Health Center, Inc	IL	Federally Qualified Health Center (FQHC)	$0	$143M
Primecare Community Health, Inc.	IL	Federally Qualified Health Center (FQHC)	$0	$11.3M
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$11.2M
Orbit Medical Of Chicago LLC	IL	Durable Medical Equipment & Medical Supplies	$0	$10.7M
Erie Family Health Center Inc	IL	Federally Qualified Health Center (FQHC)	$0	$9.5M
Primecare Community Health Inc	IL	Federally Qualified Health Center (FQHC)	$0	$8.5M
Primecare Community Health Inc	IL	Federally Qualified Health Center (FQHC)	$0	$5.3M
Ayman Jabr	IL	Family Medicine Physician	$193.6K	$4.3M
Lubov Klemine	IL	Family Medicine Physician	$2.3K	$3.6M
James Diesfeld	IL	Interventional Pain Medicine Physician	$32.6K	$3.5M

Presence Chicago Hospitals Network — 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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