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.

St Elizabeth Medical Center, Inc (NPI 1932187937)

St Elizabeth Medical Center, Inc is a physician assistant provider located in Erlanger, Kentucky. This profile covers 0 Medicare and 47 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, Inc
Address	1360 Dolwick Drive
City	Erlanger
State	KY
ZIP	41018
Taxonomy	Physician Assistant
NPI Enumerated	January 9, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

47 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	29,410	$40	$1.3M
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…	13,410	$30	$442.6K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5,030	$60	$296.7K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	9,360	$30	$271.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9,050	$30	$262.4K
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…	5,780	$30	$190.6K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2,940	$50	$149.8K
77014	N/A	5,330	$30	$133.3K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	4,160	$30	$116.5K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	2,770	$40	$105.2K

Showing 1–10 of 47

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

St Elizabeth Medical Center, Inc — 2 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	198	210	1,340	$160	$568K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	6	130	2,450	$60	$382.4K
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…	787	3,340	1,020	$30	$296K
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…	151	2,460	580	$40	$245K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	8	40	180	$110	$217.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	380	470	770	$20	$188.2K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	9	90	480	$60	$158.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	173	290	520	$30	$156.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	67	110	700	$60	$155.3K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	7	70	540	$70	$131.1K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$41.7K	$188.3M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$65.5M
St Elizabeth Medical Center, Inc	KY	General Acute Care Hospital	$0	$46M
St Elizabeth Medical Center, Inc	KY	Critical Access Hospital	$0	$35.4M
St Elizabeth Medical Center, Inc	IN	General Acute Care Hospital	$0	$4.6M
St Elizabeth Medical Center, Inc	KY	Community Based Hospice Care Agency	$0	$3M
Peter Fried	OH	Radiation Oncology Physician	$904.7K	$0
Shoaib Ahmad	OK	Pulmonary Disease Physician	$276.1K	$0
William Willmott	KY	Sleep Medicine (Internal Medicine) Physician	$264.9K	$0
Mohamad Sinno	KY	Clinical Cardiac Electrophysiology Physician	$246.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Medical Group, Inc	KY	Family Medicine Physician	$0	$95.1M
Rural Metro Of Southern Ohio Inc	KY	Land Ambulance	$910.6K	$1.8M
City Of Erlanger	KY	Ambulance	$188.4K	$469.1K
Stephen Hamilton	KY	Sports Medicine (Orthopaedic Surgery) Physician	$235.9K	$0
Justin Kruer	KY	Interventional Pain Medicine Physician	$202.2K	$0
Tyler Ryan	KY	Clinical Psychologist	$152K	$0
David Sower	KY	Sports Medicine (Emergency Medicine) Physician	$115.6K	$0
James Flanagan	KY	Emergency Medicine Physician	$80.6K	$0
Michelle Howell	KY	Optometrist	$32.1K	$0
Richard Ohmer	KY	Family Medicine Physician	$28.9K	$0

St Elizabeth Medical Center, Inc — Billing Profile & Reimbursement Data

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St Elizabeth Medical Center, Inc — 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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