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

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

Holzer Hospital Foundation (NPI 1942256888)

Field	Value
Entity Type	Organization
Organization	Holzer Hospital Foundation
Address	100 Jackson Pike
City	Gallipolis
State	OH
ZIP	45631
Taxonomy	Rural Acute Care Hospital
NPI Enumerated	May 25, 2006

Payer Source	Total Paid
Medicaid	$121.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the data: there is no Medicare billing on file while Medicaid accounts for $121.3M in lifetime revenue. That concentration makes the organization highly exposed to Medicaid payment policy and utilization trends rather than Medicare dynamics.

Revenue is highly concentrated in a small set of codes: the top three Medicaid codes by revenue account for 78.7% of this provider's total Medicaid revenue. In particular, G0463 alone represents $74.6M or 69.7% of Medicaid revenue, signaling a concentrated dependence on a single high‑volume outpatient visit code.

The code mix points to a combined outpatient clinic and emergency services operation. G0463 (Hospital outpatient clinic visit for assessment and management of a patient) dominates the revenue base, while ED E/M codes 99284 ($5M, 4.7%) and 99283 ($4.7M, 4.4%) indicate substantial emergency department activity handling moderate and low complexity visits.

Competitive standing for the outpatient clinic activity is strong: G0463 ranks #3 of 151 providers in-state (99th percentile; notably above typical state volume), indicating a dominant statewide position for this specific outpatient clinic visit. That rank suggests Holzer Hospital Foundation is one of the leading providers in Ohio for billed hospital outpatient clinic visits.

By contrast, the ED evaluation codes reflect a mid‑to‑high presence but not market dominance: 99284 ranks #97 of 655 (85th percentile; typical, unremarkable volume) and 99283 ranks #97 of 484 (80th percentile; typical, unremarkable volume). These percentiles indicate steady emergency department throughput without the same outsized market share seen in the outpatient clinic line.

Specialty testing and lab-related services appear as meaningful ancillary revenue lines: 0241U ($2.4M, 2.3%) ranks #7 of 88 (93th percentile; notably above typical), and 0240U ($1.2M, 1.1%) ranks #1 of 16 (100th percentile; notably above typical). Additional lab and infectious disease testing codes such as U0003 ($1.4M, 1.3%) and 87633 ($697.2K, 0.7%) further support a notable testing and diagnostics footprint beyond core clinical visits.

The provider’s service mix includes imaging, endoscopy, infusion and therapy lines that diversify revenue beyond visits: 70450 (CT head) accounts for $1.6M (1.5%), 74177 (CT abdomen/pelvis with contrast) $1.3M (1.2%), and 43239 (EGD with biopsy) $1.2M (1.1%). Infusion and IV codes such as 96361 ($2.8M, 2.6%) and 96365/96366 (combined infusion activity) plus physical therapy 97110 ($1.5M, 1.4%) indicate on‑site procedural and rehabilitative capacity that complements the outpatient and ED volumes.

The provider has long tenure in the NPI registry, enumerated on 2006-05-25 (~20 years ago), which supports interpretation of these patterns as established operational behaviors rather than transient activity spikes. Given the heavy reliance on Medicaid and the outsized share driven by G0463, strategic or reimbursement shifts in Medicaid outpatient clinic billing would materially affect the provider’s revenue profile.

Medicaid: Complete Services Breakdown

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

503 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	710,040	$110	$74.6M
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.	33,140	$150	$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.	31,000	$150	$4.7M
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.	7,960	$350	$2.8M
0241U	N/A	12,550	$190	$2.4M
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.	5,230	$310	$1.6M
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…	15,580	$100	$1.5M
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…	6,330	$220	$1.4M
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.	4,070	$320	$1.3M
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.	2,580	$470	$1.2M

Showing 1–10 of 503

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Holzer Hospital Foundation — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

503 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	3	150	4,030	$100	$5.9M
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.	54	170	4,660	$300	$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.	97	480	4,510	$90	$1.8M
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.	97	660	460	$90	$1.5M
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.	193	580	510	$100	$1.3M
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…	23	140	1,130	$90	$1.1M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	54	80	910	$110	$884.9K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	20	80	100	$860	$719.1K
J0585	Injection, onabotulinumtoxina, 1 unit	11	60	250	$730	$707.7K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	35	40	100	$850	$680.6K

Showing 1–10 of 503

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Holzer Medical Center Jackson	OH	Critical Access Hospital	$0	$16.1M
Raul Gagucas	OH	Anatomic Pathology & Clinical Pathology Physician	$193.2K	$70
Yan Chen	OH	Anatomic Pathology & Clinical Pathology Physician	$7.9K	$66.7K
Lori Russell	OH	Certified Registered Nurse Anesthetist	$46.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Holzer Clinic, LLC	OH	Multi-Specialty Clinic/Center	$0	$56.1M
Gallia County Commissioners	OH	Public Health or Welfare Agency	$135.7K	$1.8M
Gallia County Commissioners	OH	Ambulance	$335.5K	$955.2K
Jonathan Hess	OH	Family Medicine Physician	$272.3K	$0
Steven Conley	OH	Diagnostic Radiology Physician	$235.6K	$0
Dean Siciliano	OH	Diagnostic Radiology Physician	$229.1K	$0
Divya Arora	OH	Radiation Oncology Physician	$150.7K	$0
Rajesh Rajan	OH	Nephrology Physician	$150.4K	$0
Choudhary Rayani	OH	Clinical Cardiac Electrophysiology Physician	$141.6K	$0
Beenu Singh	OH	Nephrology Physician	$139.3K	$0

Holzer Hospital Foundation — 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