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.

Mount Carmel Health System (NPI 1982784534)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mount Carmel Health System
Address	6001 E Broad St
City	Columbus
State	OH
ZIP	43213
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 17, 2006

Payer Source	Total Paid
Medicaid	$66.7M
Medicare	$0

Payer mix is effectively single-payer: this provider has no Medicare billing on file and reports $66.7M in Medicaid revenue, indicating Medicaid is the operational and revenue focus rather than a dual Medicare/Medicaid balance. The absence of Medicare activity should reframe benchmarking and contracting analyses to Medicaid-dominated performance metrics.

Revenue is highly concentrated in a small set of Medicaid codes: the precomputed top-3 Medicaid codes (99283, 99284, 96361) account for 50.1% of total Medicaid revenue. Individually those codes are listed as 99283 $11.6M (22.6%), 99284 $8.5M (16.5%), and 96361 $5.7M (11.1%), so payers should prioritize these services when assessing utilization drivers.

Clinical and service-line mix points to a high-volume emergency department and infusion/acute outpatient treatment model: the top revenue-driving codes are emergency department E/M codes (99283, 99284, 99282, 99285, 99281) combined with infusion/dehydration management codes (96361, 96360, 96366). High claim counts (for example 84.8K claims for 99283 and 57.3K for 99284) and the presence of observation (G0378) reinforce that ED throughput and short-term acute care/infusions are core operational lines.

Competitive standing within the state is strong for several ED acuity levels: 99283 ranks #28 of 484 providers (94th percentile; notably above typical state volume), 99282 ranks #5 of 232 (98th percentile; notably above typical state volume), and 99281 ranks #7 of 128 (95th percentile; notably above typical state volume). These rankings indicate the provider is a major in-state ED participant for multiple visit levels and should be treated as a key competitor or network anchor for emergency services.

Some high-revenue imaging and diagnostic services support the ED and inpatient workup but show largely typical in-state volumes: 70450 (CT head without contrast) reports $2.2M (rank #48 of 286, 84th percentile; typical, unremarkable), 74177 (CT abdomen/pelvis with contrast) reports $1.9M (rank #44 of 280, 85th percentile; typical, unremarkable), and 71275 (CTA chest) reports $566.2K (rank #33 of 170, 81st percentile; typical, unremarkable). These lines add meaningful revenue and diagnostic capacity without the same above-typical dominance seen in core ED codes.

The provider volumes include notable public-health or surveillance activity: C9803 (SARS-CoV-2 outpatient specimen collection) has 24K claims and $913.9K revenue and ranks #4 of 67 providers (95th percentile; notably above typical state volume), signaling a high outpatient testing throughput relative to peers and an operational role in infectious disease testing. This may be relevant for pandemic-response contracting or community testing arrangements.

Obstetric and women’s services contribute measurable Medicaid revenue but sit at mid-to-high statewide percentiles: 59025 (fetal heart rate testing) reports $1.3M (rank #19 of 204, 91st percentile; typical, unremarkable) and 76816 (follow-up fetal ultrasound) reports $1.2M (rank #26 of 185, 86th percentile; typical, unremarkable). These figures indicate maternity-related diagnostics are consistent revenue contributors and should be included when evaluating service-line breadth.

Provider tenure is long-standing: NPI enumerated on 2006-10-17 (~20 years ago), which supports interpreting current patterns as established operational behavior rather than transient or newly formed practice; contracting and utilization-management strategies can therefore assume stability in service mix when engaging this provider.

Medicaid: Complete Services Breakdown

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

472 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.	84,770	$140	$11.6M
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.	57,260	$150	$8.5M
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.	15,900	$360	$5.7M
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.	34,200	$120	$4.2M
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.	28,910	$140	$4.1M
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.	7,840	$280	$2.2M
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.	6,710	$280	$1.9M
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	7,180	$180	$1.3M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	7,780	$150	$1.2M
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…	9,680	$120	$1.1M

Showing 1–10 of 472

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

Mount Carmel Health System — 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

472 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	84	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.	29	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.	28	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.	48	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.	66	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…	72	140	1,130	$90	$1.1M
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	27	50	220	$30	$675.9K
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.	48	290	1,380	$90	$635.2K
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.	44	280	1,110	$110	$605.7K
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.	5	230	2,200	$100	$530.1K

Showing 1–10 of 472

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohiohealth Corporation	OH	Family Medicine Physician	$0	$89.1M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$42.4M
Mount Carmel Health System	OH	General Acute Care Hospital	$0	$14.4M
Mount Carmel Healthproviders Inc	OH	Family Medicine Physician	$0	$9.5M
Trinity Home Health Services	OH	Community Based Hospice Care Agency	$0	$8.9M
Mount Carmel Health System	OH	Sleep Disorder Diagnostic Clinic/Center	$73.8K	$402.6K
Joel Politi	OH	Orthopaedic Surgery Physician	$351.7K	$0
Emal Sherzai	OH	Internal Medicine Physician	$251.1K	$0
Derek Snook	OH	Orthopaedic Surgery of the Spine Physician	$243.5K	$0
Mark Knapp	OH	Hematology & Oncology Physician	$223K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lighthouse Behavioral Health Solutions, LLC	OH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$116.4M
Access Ohio, LLC	OH	Community/Behavioral Health Agency	$0	$72.4M
Independent Home Care Inc.	OH	Home Health Agency	$0	$47.5M
The Buckeye Ranch, Inc	OH	Adolescent and Children Mental Health Clinic/Center	$0	$32.5M
Caring Heart Home Health Agency LLC	OH	Home Health Agency	$0	$24.3M
Golden Rule Home Health Care LLC	OH	Home Health Agency	$0	$13.8M
Columbia Home Health Care Inc	OH	Home Health Agency	$0	$11.7M
Alta Home Health Care, LLC	OH	Home Health Agency	$0	$10.4M
Hospitalist Medicine Physicians Of Ohio, Professional Corporation	OH	Internal Medicine Physician	$0	$9.7M
Lifesaver Health Care, LLC	OH	Home Health Agency	$0	$9.6M

Mount Carmel Health System — 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