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

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

Mercy Hospital Carthage (NPI 1003201955)

Field	Value
Entity Type	Organization
Organization	Mercy Hospital Carthage
Address	3125 Dr Russell Smith Way
City	Carthage
State	MO
ZIP	64836
Taxonomy	Critical Access Hospital
NPI Enumerated	March 30, 2015

Payer Source	Total Paid
Medicaid	$18.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

68 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.	39,550	$120	$4.8M
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.	19,530	$150	$2.9M
Y7506	N/A	18,150	$140	$2.6M
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.	8,760	$230	$2M
X4011	N/A	4,220	$220	$911.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	10,340	$80	$827K
X4006	N/A	1,100	$720	$790.9K
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.	8,230	$80	$625.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,390	$180	$430.4K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	4,620	$80	$387.7K

Showing 1–10 of 68

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Missouri Distribution

Mercy Hospital Carthage — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Missouri

Full comparison — all codes billed, vs. Missouri median

68 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	64	110	5,700	$340	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	39	100	2,240	$80	$2.2M
Y7506	N/A	12	100	980	$250	$1.6M
X4003	N/A	24	70	1,480	$80	$1.1M
X4006	N/A	15	50	370	$780	$969.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	48	90	1,850	$120	$384.1K
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	600	140	$170	$384.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	66	110	2,100	$70	$364.3K
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.	63	240	1,740	$40	$353.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	59	320	980	$40	$352.7K

Showing 1–10 of 68

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mercy Hospital Springfield	MO	General Acute Care Hospital	$0	$64.5M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Mercy Hospital Joplin	MO	General Acute Care Hospital	$0	$46.7M
Mercy Hospital Springfield	MO	Land Ambulance	$0	$46.7M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$15.1M
Adam Carver	MO	Ophthalmology Physician	$2.2M	$0
Erica Ballard	MO	Ophthalmology Physician	$1.4M	$0
Robert Blair	HI	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M
Patrick Gomez	IL	Hematology & Oncology Physician	$990.5K	$94.3K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunshinechildrenshomeinc	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$7.6M
Jonathan Manzer	MO	Family Medicine Physician	$320.1K	$74K
Teryn Mcgrew	MO	Family Nurse Practitioner	$161.5K	$0
Jonathan Haffner	MO	Family Medicine Physician	$155.6K	$0
Lawrence Andrade	MO	Family Medicine Physician	$64.4K	$0
Gretchen Barone	MO	Adult Health Nurse Practitioner	$40.6K	$0
Joan Dutton	MO	Acute Care Nurse Practitioner	$29.7K	$0
Martin Pharmacy Services, LLC	MO	Community/Retail Pharmacy	$20.2K	$1.5K

Mercy Hospital Carthage — Billing Profile & Reimbursement Data

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Mercy Hospital Carthage — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References