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

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

Biloxi Hma LLC (NPI 1972557064)

Key Findings

Field	Value
Entity Type	Organization
Organization	Biloxi Hma LLC
Address	150 Reynoir St
City	Biloxi
State	MS
ZIP	39530
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$25.7M
Medicare	$0

This facility has no Medicare billing on file and all reported federal payer revenue is Medicaid-only: Total Medicaid revenue is $25.7M. That makes the provider effectively single‑payer in the available federal claims dataset, which concentrates exposure to Medicaid contracting and reimbursement policy for analysis and negotiation.

Revenue concentration is high: the precomputed top three Medicaid codes account for 47.5% of the provider’s total Medicaid revenue, led by 99283 ($4.4M, 21.0%), 99284 ($3.5M, 16.5%), and 43239 ($2.1M, 9.9%). This indicates a narrow set of services drives nearly half of reported Medicaid cash flow and should be a priority when modeling revenue risk and utilization.

The code mix points to a high-volume emergency department plus observation and procedural services. The top two revenue codes are ED E/M visits (99283: 34.4K claims, $129 avg paid/claim, $4.4M revenue; 99284: 20.1K claims, $173 avg paid/claim, $3.5M revenue) and the hospital observation code G0378 (4.2K claims, $291 avg paid/claim, $1.2M revenue). Together these line items are consistent with a general acute-care hospital that triages large ED volumes and manages substantial observation-stay throughput.

Endoscopy and GI procedures are a material secondary service line. Upper endoscopic biopsy 43239 accounts for $2.1M (9.9%) of Medicaid revenue and ranks #6 of 73 in-state (93rd percentile; notably above typical state volume for this code), while colonoscopic biopsy 45380 appears as a smaller but present revenue source ($387.4K, 1.8%). These figures indicate above-average in-state capability for diagnostic endoscopy.

Ancillary inpatient and ED support services (infusion, pathology, imaging, and point-of-care testing) are meaningful revenue contributors, reflecting typical hospital workflows: 96374 $962.9K (4.6%), 88305 $956.3K (4.5%), 74177 $504.9K (2.4%), and 87426 $350.9K (1.7%). The presence of both infusion and pathology revenue supports inpatient/ED procedural throughput and downstream lab/imaging demand.

Competitive standing across codes is mixed: the provider is a leading state-level performer for some discrete services (43239 is notably above typical; 99281 ranks #5 of 84, 95th percentile and is noted as notably above typical), while its highest-revenue ED codes (99283 and 99284) are described as “typical, unremarkable volume” despite large claim counts and occupy solid mid-to-high percentiles. In sum, the hospital is regionally important for several niche services but not uniformly dominant across all top revenue lines.

Specific statistical outliers flagged in the data merit attention for capacity and operational planning: 43239 is listed as notably above typical state volume (rank #6/73, 93rd percentile), 99281 is noted as notably above typical state volume (rank #5/84, 95th percentile), and 87426 is also described as notably above typical state volume (rank #12/438, 97th percentile). These labels suggest exceptional state-level volume in targeted diagnostics and low-acuity ED presentations.

The provider’s NPI was enumerated on 2006-05-22 (~20 years ago), indicating long tenure in the market; the combination of established ED volume, observation services, and procedural/state-leading endoscopy capacity is consistent with an established general acute care hospital footprint rather than a newly opened facility.

Medicaid: Complete Services Breakdown

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

240 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.	34,350	$130	$4.4M
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.	20,130	$170	$3.5M
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.	4,740	$440	$2.1M
G0378	Hospital observation service, per hour	4,180	$290	$1.2M
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.	5,740	$210	$1.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,460	$80	$962.9K
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…	7,780	$120	$956.3K
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.	8,590	$80	$704.3K
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…	9,680	$50	$522.5K
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.	2,900	$170	$504.9K

Showing 1–10 of 240

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Biloxi Hma LLC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

240 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	21	70	1,480	$370	$1.4M
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.	40	230	3,260	$120	$1.4M
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.	20	220	5,690	$100	$1.2M
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.	53	180	3,000	$140	$1.1M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	24	90	4,540	$90	$665.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	20	90	2,110	$80	$325.8K
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.	40	110	1,250	$110	$311.6K
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…	42	220	1,590	$50	$291.3K
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.	18	150	2,200	$70	$280.7K
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…	853	1,910	930	$60	$278.7K

Showing 1–10 of 240

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seashore Oaks Assisted Living	MS	Assisted Living Facility	$0	$3.6M
Bio-medical Applications Of Mississippi, Inc.	MS	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Coastal Family Health Center, Inc	MS	Federally Qualified Health Center (FQHC)	$0	$1.5M
Yashashree Bethala	MS	Internal Medicine Physician	$307.5K	$0
Michael Hogan	MS	Vascular Surgery Physician	$215.9K	$0
Gholam Motakhaveri	MS	Internal Medicine Physician	$210.4K	$0
Bennett Cheney	MS	Internal Medicine Physician	$181.7K	$0
Andrew Peterson	MS	Internal Medicine Physician	$173.3K	$0
John Nelson	MS	Anatomic Pathology & Clinical Pathology Physician	$30.2K	$41.8K
Dustin Yontz	MS	Diagnostic Radiology Physician	$66.3K	$0

Biloxi Hma LLC — 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

Nearby Providers

Frequently Asked Questions

References