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 Clinic Springfield Communities (NPI 1053350454)

Mercy Clinic Springfield Communities is a family medicine physician provider located in Hollister, Missouri. This profile covers 0 Medicare and 157 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Mercy Clinic Springfield Communities
Address	290 Clift Ct
City	Hollister
State	MO
ZIP	65672
Taxonomy	Family Medicine Physician
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

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

157 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	104,770	$60	$6.3M
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…	65,430	$70	$4.6M
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,950	$100	$495K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,430	$100	$425.3K
99203	The provider sees a new 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 provider…	3,900	$90	$339.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3,220	$100	$331.4K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	3,390	$80	$264.5K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	3,540	$60	$201.6K
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.	3,120	$60	$196.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2,980	$50	$157.8K

Showing 1–10 of 157

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 Clinic Springfield Communities — 11 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

157 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	113	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…	116	320	980	$40	$352.7K
0241U	N/A	45	80	330	$110	$192.3K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	19	40	200	$160	$143.1K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	11	30	50	$650	$137.5K
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…	16	3,170	230	$70	$128.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	127	590	260	$40	$120.5K
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…	7	4,310	300	$60	$110.8K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	103	120	130	$60	$103K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	9	70	130	$190	$97.4K

Showing 1–10 of 157

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Medical Center Of Akron	OH	Children's Hospital	$0	$556.2M
Children's Hospital Medical Center Of Akron	OH	Pediatrics Physician	$0	$87.2M
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
Phelps County Regional Medical Center	MO	General Acute Care Hospital	$0	$38.3M
Mercy Clinic Joplin LLC	MO	Family Medicine Physician	$0	$20.4M
Mercy Hospital Carthage	MO	Critical Access Hospital	$0	$18.8M
Pcrmc Medical Group, Inc	MO	Clinic/Center	$0	$11.4M

Mercy Clinic Springfield Communities — Billing Profile & Reimbursement Data

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Mercy Clinic Springfield Communities — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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