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.

Lester E Cox Medical Centers (NPI 1093740128)

Field	Value
Entity Type	Organization
Organization	Lester E Cox Medical Centers
Address	3801 S National Ave
City	Springfield
State	MO
ZIP	65807
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 11, 2006

Payer Source	Total Paid
Medicaid	$112.3M
Medicare	$0

Key Findings

LESTER E COX MEDICAL CENTERS reports no Medicare billing on file and $112.3M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer Medicaid at the aggregate level. The absence of Medicare revenue suggests analysts should treat Medicaid patterns as the primary source of operational and contracting insight for this facility.

Revenue is highly concentrated: the precomputed top three Medicaid codes — X4011, Y7506, and 99285 — together account for 38.6% of this provider's total Medicaid revenue. In particular X4011 alone contributes $20.8M (20.7% of Medicaid revenue), indicating a single code drives a very large share of the hospital’s Medicaid receipts.

The code mix strongly indicates a high-volume emergency department and hospital outpatient operation: 99285 has 22.1K claims and $8.4M revenue (8.4%), 99284 has 28.4K claims and $7.7M revenue (7.7%), and 99283 has 33.8K claims and $6.5M revenue (6.5%). All three ED E/M codes rank in the top percentiles statewide (99285 at the 97th percentile, 99284 and 99283 at the 99th percentile) and are labeled as extreme outliers, consistent with a major ED serving large Medicaid volumes.

Laboratory, diagnostic, and outpatient clinic services are also large revenue drivers: 85025 (CBC) reports 128.9K claims and $6.8M (6.8%) and ranks at the 100th percentile, 80053 (CMP) reports 125.9K claims and $6.5M (6.5%) and ranks at the 100th percentile, and G0463 (hospital outpatient clinic visit) accounts for $7M (6.9%) across 82.8K claims. Multiple high-volume lab and imaging codes (81001, 93005, 71045/71046, 80306, 83690) are in top statewide percentiles, indicating the hospital functions as a regional lab/imaging hub supporting its ED and outpatient clinics.

Competitive standing within Missouri is dominant on many measures: X4011 ranks #1 of 106 providers in‑state at the 100th percentile (extreme outlier), and several lab/test codes (80053, 81001, 80306, 83690) are also at or near #1 statewide with 100th‑percentile designations. These rank and percentile signals identify the facility as a major statewide participant for those services rather than a modest or fringe provider.

Several high-revenue codes lack public descriptors (notably X4011, X4006, X4003 and D7999) but appear among the top revenue drivers (X4011 $20.8M; X4006 $2.1M; X4003 $1.6M; D7999 $1.4M). Because an undescribed code (X4011) is the single largest Medicaid revenue source, analysts should verify local code mappings, bundling, and contract interpretations when using these lines for service-line planning or reimbursement benchmarking.

The provider also shows significant activity in ancillary therapeutic and testing services: 96374 (IV medication administration) has $1.9M (1.9%) and ranks in the 96th percentile, while G0480 (definitive drug testing) contributes $1.8M (1.7%) and ranks #2 of 62 providers (98th percentile). High volumes and ranks in both infusion/administration and definitive toxicology testing point to integrated clinical, pharmacy, and laboratory operations supporting acute care workflows.

LESTER E COX MEDICAL CENTERS has an NPI enumeration date of 2006-07-11 (~20 years ago), indicating an established provider presence and likely mature referral networks and infrastructure. Combined with the concentrated Medicaid revenue and repeated top‑percentile rankings across ED, lab, and imaging codes, the tenure supports a sustained, high-capacity role in the state Medicaid ecosystem.

Medicaid: Complete Services Breakdown

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

184 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
X4011	N/A	72,140	$290	$20.8M
Y7506	N/A	21,560	$440	$9.6M
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.	22,060	$380	$8.4M
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.	28,360	$270	$7.7M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	82,770	$80	$7M
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…	128,880	$50	$6.8M
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.	125,910	$50	$6.5M
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.	33,840	$190	$6.5M
81001	Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other…	87,840	$70	$5.7M
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…	35,480	$70	$2.3M

Showing 1–10 of 184

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

Lester E Cox Medical Centers — 17 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

184 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
X4011	N/A	1	110	5,700	$340	$3.2M
X4014	N/A	5	10	1,070	$1,030	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	9	100	2,240	$80	$2.2M
Y7506	N/A	8	100	980	$250	$1.6M
X4003	N/A	12	70	1,480	$80	$1.1M
X4006	N/A	13	50	370	$780	$969.5K
A0425	Ground mileage, per statute mile	193	200	3,230	$90	$827.5K
D7999	N/A	2	20	190	$2,300	$708.3K
Y7507	N/A	9	50	270	$360	$594.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	5	90	1,850	$120	$384.1K

Showing 1–10 of 184

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lester E Cox Medical Centers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Partners Physician Group	OH	Surgery Physician	$0	$28.5M
Lester E Cox Medical Centers	MO	Land Ambulance	$0	$25.8M
Skaggs Community Hospital Association	MO	General Acute Care Hospital	$0	$18.8M
Lester E Cox Medical Centers	MO	Family Medicine Physician	$0	$17M
Lester E Cox Medical Centers	MO	General Practice Physician	$0	$9.2M
Levent Akduman	MO	Ophthalmology Physician	$3.1M	$1.4M
Robert Dorsey	FL	Surgery Physician	$4.3M	$0
Lester E. Cox Medical Centers	MO	Durable Medical Equipment & Medical Supplies	$0	$3.5M
Juanita Golden-allen	MO	Acute Care Nurse Practitioner	$2.9M	$0
Richard Jones	MO	Ophthalmology Physician	$1M	$0

Nearby Providers

Other providers in the same ZIP code as Lester E Cox Medical Centers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Supported Living And Employment Services, Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$276.6M
Easy Living Inc.	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$183.2M
Healthcare Services Of The Ozarks, Inc	MO	Home Health Agency	$0	$60.3M
Mercy Clinic Springfield Communities	MO	Family Medicine Physician	$0	$51.5M
Abilities First	MO	Case Management Agency	$0	$45.8M
Southwest Center For Independent Living	MO	In Home Supportive Care Agency	$0	$45.3M
Seniorage Area Agency On Aging	MO	Case Management Agency	$0	$19.2M
Maxim Healthcare Services, Inc.	MO	Home Health Agency	$0	$17.7M
Phoenix Home Care, LLC	MO	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.5M
Honour Brite LLC	MO	Multi-Specialty Clinic/Center	$0	$7.1M

Lester E Cox Medical Centers — 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