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

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

Henry Ford Health St. John Hospital (NPI 1023088168)

Field	Value
Entity Type	Organization
Organization	Henry Ford Health St. John Hospital
Address	3187 Solutions Ctr
City	Chicago
State	IL
ZIP	60677
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 23, 2006

Payer Source	Total Paid
Medicaid	$159.7M
Medicare	$0

Key Findings

Provider has no Medicare billing on file and is effectively a Medicaid-focused facility: lifetime Medicaid revenue is $159.7M and there is no recorded Medicare revenue, indicating the provider operates primarily within the Medicaid market rather than a mixed payer mix. The NPI was enumerated on 2006-01-23 (~20 years ago), confirming long tenure in the state market.

Revenue is highly concentrated in a small set of emergency department visit codes: the precomputed top three Medicaid codes (99285, 99284, 99283) account for 46.9% of the provider's total Medicaid revenue. Individually those codes are large revenue drivers (99285 $25.2M, 99284 $13.9M, 99283 $13.8M) and together they point to a business model heavily weighted toward ED services.

Operational profile is dominated by high-volume emergency and outpatient assessment activity: 99285 (60.9K claims, $25.2M) is reported as an extreme outlier in-state, 99284 (81.4K claims, $13.9M) and 99283 (102.9K claims, $13.8M) are also extreme outliers, and G0463 (215.3K claims, $11.4M) ranks #1 in-state as an extreme outlier. This mix indicates continuous, large-scale ED throughput plus substantial hospital outpatient clinic assessment and management activity.

The provider functions as a significant regional hub for urgent, observation, and critical care transitions: G0378 observation services (28.4K claims, $8.2M) rank #1 of 2 in-state, and critical care 99291 (3.5K claims, $1.9M) ranks in the 98th percentile as an extreme outlier. Those patterns suggest frequent ED-to-observation throughput and capacity to deliver intensive/critical care when required.

There is a notable oncology and infusion service line presence: high-cost immunotherapy J9271 (861 claims, $4.9M) ranks #1 of 2 in-state, chemotherapy 96413 (13.1K claims, $2.1M) ranks #1 of 149 (100th percentile; extreme outlier), and infusion administration codes (96374, 96365, 96360/61) together generate multi-million dollar revenue. These code-level signals indicate the hospital delivers significant ambulatory/inpatient infusion and oncology services as part of its case mix.

Laboratory and routine diagnostic testing volumes are large and concentrated, supporting the high outpatient/ED throughput: 87491 (141.2K claims, $2.5M) and 87591 (140.6K claims, $2.5M) are notably above typical state volume, 82306 (134K claims, $2.3M) and 84443 (198.7K claims, $2M) are extreme outliers, and panels like 80061 (196.6K claims, $2.2M) and 80053 (259.9K claims, $1.3M) show very high claim counts. The lab footprint appears centralized and scaled to support both ED and ambulatory populations.

State-level competitive standing is dominant for several top services: 99285 ranks #2 of 2479 providers in-state (100th percentile; extreme outlier), 99284 and 99283 also rank at the 100th percentile, and G0463 ranks #1 of 28 providers (100th percentile; extreme outlier). Across key ED, outpatient clinic, infusion, and many lab codes the provider consistently appears as a major statewide player rather than a modest participant.

Because nearly half of Medicaid revenue is concentrated in three ED codes and the facility reports no Medicare billing, the provider's financial performance is particularly sensitive to Medicaid reimbursement and ED utilization trends. The combination of very high ED volumes, substantial observation hours, and a large lab/infusion footprint suggests that policy or utilization shifts in any of those areas could materially affect revenue given the single-payer concentration and top-code dependence.

Medicaid: Complete Services Breakdown

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

752 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	60,870	$410	$25.2M
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.	81,360	$170	$13.9M
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.	102,910	$130	$13.8M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	215,310	$50	$11.4M
G0378	Hospital observation service, per hour	28,350	$290	$8.2M
J9271	Injection, pembrolizumab, 1 mg	860	$5,670	$4.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	52,490	$80	$3.9M
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.	29,190	$100	$2.8M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	141,170	$20	$2.5M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	140,640	$20	$2.5M

Showing 1–10 of 752

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Illinois Distribution

Henry Ford Health St. John Hospital — 25 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Illinois

Full comparison — all codes billed, vs. Illinois median

752 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	1	10	14,190	$290	$4.1M
Q5103	Injection, infliximab-dyyb, biosimilar, (inflectra), 10 mg	2	10	2,450	$1,070	$2.6M
J9271	Injection, pembrolizumab, 1 mg	1	10	450	$5,630	$2.5M
G0480	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…	13	70	570	$50	$565.6K
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…	32	350	400	$70	$514.7K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	19	80	530	$130	$505.1K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1	30	50	$50	$422.6K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	112	130	70	$120	$240.2K
96360	The provider introduces a catheter intravenously for supplementation of fluid and electrolytes for 31 minutes to one hour to treat severe cases of dehydration.	1	10	200	$90	$230K
J0897	Injection, denosumab, 1 mg	2	10	90	$530	$225.9K

Showing 1–10 of 752

Related Providers

Other providers that share a Tax Identification Number (TIN) with Henry Ford Health St. John Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Henry Ford Health Providence Hospital	MI	General Acute Care Hospital	$0	$72.8M
Henry Ford Health St. John Hospital	MI	Internal Medicine Physician	$0	$41.8M
Henry Ford Macomb Hospital Corporation	MI	Family Medicine Physician	$0	$9.2M
Henry Ford Health Providence Hospital	MI	Obstetrics & Gynecology Physician	$0	$9M
Adli Yakan	MI	Medical Oncology Physician	$1.7M	$0
Andrew Muskovitz	MI	Hematology & Oncology Physician	$1.2M	$0
Srinivas Koneru	MI	Cardiovascular Disease Physician	$984.1K	$0
Herman Kado	MI	Cardiovascular Disease Physician	$771.5K	$0
Lokesh Nagori	MI	Medical Oncology Physician	$719.1K	$0
Zakwan Mahjoub	MI	Interventional Cardiology Physician	$687K	$0

Henry Ford Health St. John Hospital — 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

Frequently Asked Questions

References