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

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

Beloit Health System Inc (NPI 1982780094)

Key Findings

Field	Value
Entity Type	Organization
Organization	Beloit Health System Inc
Address	1969 W Hart Rd
City	Beloit
State	WI
ZIP	53511
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 31, 2006

Payer Source	Total Paid
Medicaid	$22.7M
Medicare	$0

BELOIT HEALTH SYSTEM INC reports no Medicare billing on file and therefore operates, in our dataset, as effectively a single-payer (Medicaid) public-revenue provider; total Medicaid revenue on file is $22.7M and there is no Medicare revenue to benchmark against national peers. Because Medicare activity is absent, competitive assessments and national Medicare comparisons are not possible from claims data alone.

Revenue concentration is high: the precomputed top three Medicaid codes (99283, 99284, 96361) together account for 39.5% of the provider's total Medicaid revenue. Individually those codes are 99283: $2.9M (18.4%), 99284: $1.9M (12.1%), and 96361: $1.4M (9.0%), indicating a concentrated share of Medicaid dollars tied to a few high-volume services.

The code mix points to a heavy emergency-department and acute-care operational focus. High revenue and claim counts for ED E/M codes 99283 ($2.9M), 99284 ($1.9M), 99282 ($1.2M) and 99285 ($868.9K) combined with substantial IV/infusion codes (96361 $1.4M; 96365 $338.9K; 96360 $274.8K) suggest the hospital delivers large volumes of ED visits and IV/infusion treatments—consistent with frequent management of dehydration, infusion therapies, and acute presentations.

Lab and outpatient diagnostic services are also a meaningful ancillary revenue stream. High-claim lab codes such as 80053 (45K claims, $720.1K), 80048 (28.2K claims, $450.8K), 87591/87491 (13.1K/13K claims, $392K/$389K) and COVID/respiratory testing 87635 (8.5K claims, $315.7K) show substantial testing volume that supports ED and outpatient workflows and contributes materially to the $22.7M Medicaid tally.

State-level competitive standing is mixed but includes several clear strengths: 99283 ranks #10 of 362 in-state (98th percentile) and 99282 ranks #9 of 191 (96th percentile), both described as "notably above typical state volume," indicating the hospital is a regional leader for certain ED visit intensities. Other high-percentile placements include 0241U (#3 of 100, 98th percentile), 81001 (#7 of 204, 97th percentile), and 87651 (#9 of 163, 95th percentile), which together imply above-typical market share for select testing and ED services within the state.

Several commonly billed codes remain at typical volumes versus peers, reflecting standard hospital service lines rather than outlier specialization. Examples labeled "typical, unremarkable volume" include 99284 (95th percentile), 99285 (91st percentile), 80053 (93rd percentile), and many clinic/outpatient E/M codes such as 99214 and 99213; these placements indicate a consistent, broad acute and outpatient practice rather than extreme specialization across all services.

The presence of advanced endoscopic procedures and associated biopsy codes suggests maintained specialty capacity beyond frontline ED care. Procedure codes like 43239 ($397.4K) and 45380 ($271.4K, ranked #6 of 78 and noted as "notably above typical state volume") indicate active gastroenterology procedural throughput that complements the hospital's acute-care and testing volumes.

Operational tenure is long enough to reflect an established local presence: the NPI was enumerated 2006-10-31 (~20 years ago), which supports interpretation that current billing patterns represent mature service-line choices rather than a nascent provider learning curve.

Medicaid: Complete Services Breakdown

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

379 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.	46,340	$60	$2.9M
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.	29,620	$60	$1.9M
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.	15,650	$90	$1.4M
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.	18,950	$60	$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.	14,730	$60	$868.9K
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.	45,010	$20	$720.1K
0241U	N/A	14,840	$30	$489.6K
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…	7,580	$60	$470K
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…	15,040	$30	$466.1K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	28,180	$20	$450.8K

Showing 1–10 of 379

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Wisconsin Distribution

Beloit Health System Inc — 8 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Wisconsin

Full comparison — all codes billed, vs. Wisconsin median

379 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.	13	140	3,200	$160	$1.1M
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.	10	360	1,550	$70	$614.4K
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.	21	430	760	$60	$484.6K
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…	17	20	340	$90	$462K
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.	9	190	1,790	$90	$390.9K
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.	9	140	2,200	$90	$358.4K
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.	31	330	1,350	$60	$338K
G0481	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…	19	20	510	$70	$255.3K
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.	19	260	3,590	$20	$232.2K
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.	95	190	620	$40	$226.6K

Showing 1–10 of 379

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beloit Health System Inc	WI	General Practice Physician	$0	$4.9M
Beloit Health System Inc	WI	Renal Dialysis Technician	$0	$2M
John Kapoor	CA	Internal Medicine Physician	$812.8K	$575.1K
Jason Friedrichs	FL	Ophthalmology Physician	$695K	$0
Anupama Upadhyay	IA	Psychiatry Physician	$31.6K	$560.4K
Charles Sweeney	IL	Nephrology Physician	$297.6K	$157.4K
James Starr	MI	Internal Medicine Physician	$210.9K	$0
Paul Segal	WI	Dermatology Physician	$192.2K	$830
Eric Xanthopoulos	WI	Radiation Oncology Physician	$186K	$0
Ioannis Karkatzounis	WI	Hospitalist Physician	$84.4K	$97.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Systems, Inc.	WI	Federally Qualified Health Center (FQHC)	$0	$14.2M
Orthodontic Experts Of Wisconsin, LLC	WI	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.4M
School District Of Beloit	WI	Local Education Agency (LEA)	$0	$2.8M
City Of Beloit	WI	Paramedic	$333.3K	$1.6M
Southern Wisconsin Emergency Associates Sc	WI	Emergency Medicine Physician	$0	$1.7M
Orthomidwest Surgery Center Beloit, LLC	WI	Ambulatory Surgical Clinic/Center	$415.3K	$0
Jennifer Taylor	WI	Nurse Practitioner	$185.9K	$39.7K
Walgreen Co	WI	Pharmacy	$138.3K	$55.6K
Leonard Egbujiobi	WI	Cardiovascular Disease Physician	$176.5K	$0
Charles Laham	WI	Cardiovascular Disease Physician	$123.8K	$1.2K

Beloit Health System 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