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

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

Mary Washington Hospital Inc. (NPI 1942288527)

Field	Value
Entity Type	Organization
Organization	Mary Washington Hospital Inc.
Address	1001 Sam Perry Blvd
City	Fredericksburg
State	VA
ZIP	22401
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 4, 2006

Payer Source	Total Paid
Medicaid	$80.1M
Medicare	$0

Key Findings

MARY WASHINGTON HOSPITAL INC. is effectively a Medicaid-focused provider: there is no Medicare billing on file and the provider reports $80.1M in lifetime Medicaid revenue. Its NPI was enumerated on 2006-01-04 (~20 years ago), indicating longstanding active participation in the state Medicaid market.

Revenue is highly concentrated in a small set of outpatient/ED and infusion services: the precomputed top 3 Medicaid codes (99284, 99283, 96361) account for 46.2% of the provider’s total Medicaid revenue. The single largest code, 99284, accounts for $14.4M (20.8% of Medicaid revenue), followed by 99283 at $9.1M (13.1%) and 96361 at $8.5M (12.3%).

The code mix points to a high-volume emergency department and infusion/observation operation: dominant codes include ED E/M levels 99284, 99283, 99285, and 99282 alongside IV infusion codes 96361, 96360, 96365, and 96366 and observation hours billed under G0378. This pattern is consistent with a facility that manages large numbers of acute, dehydration/infusion-related visits and routes many patients through observation rather than immediate inpatient admission.

MARY WASHINGTON is a major statewide performer for several ED and infusion codes: 99284 ranks #13 of 620 providers in-state (98th percentile; notably above typical state volume for this code), 99283 ranks #30 of 626 (95th percentile; notably above typical state volume for this code), and 96361 ranks #4 of 90 (97th percentile; notably above typical state volume for this code). These ranks indicate the hospital is a leading in-state provider for moderate-complexity ED visits and IV fluid administration.

Observation-hour billing and ED-to-observation throughput are material parts of the mix: G0378 (Hospital observation service, per hour) generated 16.4K claims and $4M in revenue (5.8% of Medicaid revenue) and ranks #5 of 80 providers in-state (95th percentile; typical, unremarkable volume for this code). The combination of high G0378 billing with elevated ED E/M codes suggests the facility funnels many ED patients into observation-level care.

The hospital maintains notable imaging and procedure capacity that supports its ED and observation volumes: 70450 (CT head without contrast) produced $2.8M (4.1% of Medicaid revenue) and ranks #19 of 174 (90th percentile), 74177 (CT abdomen/pelvis with contrast) generated $2.4M (3.5%) and ranks #21 of 178 (89th percentile), and 43239 (EGD with biopsy) produced $1.7M (2.5%) and ranks #10 of 146 (94th percentile). These results point to on-site advanced imaging and endoscopy capabilities that align with high ED caseloads.

Several codes outside the top one or two show statistically elevated in-state volumes while many others are described as typical or unremarkable: examples of notably above-typical volume include 96360 (11.3K claims, $1.3M revenue; ranks #4 of 89, 97th percentile) and 78452 (1.5K claims, $1.1M revenue; ranks #8 of 102, 93rd percentile). At the same time, a number of high-dollar services (e.g., 99285, 70450, 71275) are characterized as typical or unremarkable by their percentile and rank, indicating pockets of both outsized and routine activity across service lines.

From a payer-mix and strategic-risk perspective, the absence of any Medicare billing combined with $80.1M of Medicaid receipts means the hospital is effectively single-payer (Medicaid) in these records. Given that the top three codes account for 46.2% of Medicaid revenue, policy or rate changes affecting ED/infusion/observation services in the state Medicaid program could materially impact the provider’s reimbursement profile.

Medicaid: Complete Services Breakdown

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

392 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.	78,360	$180	$14.4M
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.	52,940	$170	$9.1M
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.	35,320	$240	$8.5M
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.	22,820	$200	$4.5M
G0378	Hospital observation service, per hour	16,420	$240	$4M
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…	13,890	$240	$3.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	25,620	$130	$3.4M
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.	19,760	$160	$3.2M
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.	14,640	$190	$2.8M
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.	11,420	$210	$2.4M

Showing 1–10 of 392

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Virginia Distribution

Mary Washington Hospital Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

392 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	4	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	13	70	3,200	$110	$2.8M
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	66	200	2,840	$320	$2.4M
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.	43	340	160	$130	$1.3M
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.	30	630	90	$140	$1.1M
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.	14	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	5	80	3,650	$160	$1M
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.	13	620	70	$120	$1M
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.	21	180	2,950	$140	$783.2K
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…	51	260	3,950	$80	$769.6K

Showing 1–10 of 392

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Memorial Hospital At Gulfport	MS	General Acute Care Hospital	$0	$87.5M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Northwest Iowa Hospital Corporation	IA	General Acute Care Hospital	$0	$22.8M
Florida Hospital Physician Group Inc	FL	Family Medicine Physician	$0	$21.4M
Memorial Hospital Flagler Inc	FL	General Acute Care Hospital	$0	$13.9M
Northwest Iowa Hospital Corporation	IA	Emergency Medical Services (Emergency Medicine) Physician	$0	$7.9M
Memorial Health Systems Inc	FL	Surgery Physician	$0	$7.4M
Daniel Novick	NY	Vascular & Interventional Radiology Physician	$3M	$658.6K
Donald Wender	IA	Hematology & Oncology Physician	$2.6M	$0

Nearby Providers

Other providers in the same ZIP code as Mary Washington Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rappahannock Area Community Services Board	VA	Community/Behavioral Health Agency	$0	$142.5M
Paragon Autism Services, LLC	VA	Behavior Analyst	$0	$21.6M
Fredericksburg Emergency Medical Alliance, Inc.	VA	Emergency Medicine Physician	$0	$15M
Mary Washington Healthcare Physicians	VA	Family Medicine Physician	$0	$13.3M
Pedsplus Urgent Care, LLC	VA	Urgent Care Clinic/Center	$0	$11M
Preferred Pediatrics At Snowden	VA	Pediatrics Physician	$0	$6.4M
Sunny Home Care Inc.	VA	Home Health Agency	$0	$6.3M
Thomas Johnson	VA	Retina Specialist (Ophthalmology) Physician	$3.6M	$0
Central Virginia Surgi-center LP	VA	Ambulatory Surgical Clinic/Center	$3.2M	$318.9K
Eric Lee	VA	Retina Specialist (Ophthalmology) Physician	$2.6M	$0

Mary Washington Hospital 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