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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

St Joseph Hospital Of Nashua Nh (NPI 1093787384)

Key Findings

Field	Value
Entity Type	Organization
Organization	St Joseph Hospital Of Nashua Nh
Address	172 Kinsley Street
City	Nashua
State	NH
ZIP	03060
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 2, 2006

Payer Source	Total Paid
Medicaid	$13M
Medicare	$0

This provider is effectively single-payer at the moment: there is no Medicare billing on file while total Medicaid revenue is $13M, indicating the facility’s recent claims activity and reported revenue are concentrated in Medicaid rather than Medicare. The absence of any Medicare billing suggests payer mix analysis and network negotiations should treat Medicaid as the material revenue source for this entity.

Revenue concentration is high across a small set of emergency-department E/M codes: the top three Medicaid codes (99284, 99285, 99283) account for 44.2% of the provider’s total Medicaid revenue. In particular, 99284 alone generated $2.2M (20.8% of Medicaid revenue) from 22K claims at $102 avg paid/claim, while 99285 generated $1.3M (11.8%) and 99283 generated $1.3M (11.6%), showing heavy dependence on ED encounters for Medicaid revenue.

The code mix and service lines point to an ED- and acute-imaging–driven operation: high-volume ED E/M codes (99284/99283/99285) combined with substantial CT utilization (74177, $888.9K; 70450, $310.2K) and observation hours (G0378, $103.1K) are consistent with a general acute care hospital that manages significant emergency throughput and diagnostic imaging. Ancillary lines such as IV infusion/administration codes (96361, 96375, 96374, 96365) and laboratory testing (87637, U0003, ) further indicate typical ED-to-observation workflows and on-site lab capacity.

Competitive standing within New Hampshire shows above-average ED volumes for several codes: 99284 ranks #5 of 76 providers in-state (95th percentile) and is explicitly described as notably above typical state volume, while 99283 ranks #5 of 66 (94th percentile) and 99285 ranks #11 of 63 (84th percentile), indicating the hospital is a major ED player regionally for moderate- and low-complexity E/M visits and a solid participant for high-complexity visits. Additionally, 99282 ranks #2 of 46 providers (98th percentile) and is also noted as notably above typical state volume, reinforcing that lower- and moderate-acuity ED visit counts are especially concentrated here.

There are notable volume-to-payment dynamics that affect revenue composition: G0463 shows very high claim volume (22K claims) but a low average paid/claim ($9) resulting in only $198.3K (1.8% of Medicaid revenue), whereas imaging and select procedures (74177 at $381 avg paid/claim and 43239 at $518 avg paid/claim) generate outsized revenue per claim. This contrast suggests the hospital’s top-line Medicaid revenue is driven both by high-volume, low-unit-payment outpatient/clinic billing and by fewer, higher-unit-payment diagnostic and procedure codes.

Several ancillary services stand out as meaningful contributors beyond ED visits: 97110 (therapeutic exercise) produced $396.1K (3.7% of Medicaid revenue) with 19.8K claims, and respiratory/viral testing codes 87637 and U0003 together contributed roughly $637K in revenue, indicating ongoing outpatient therapy and infectious-disease testing volumes that support broader outpatient capacity. These non-ED lines diversify revenue but remain secondary to ED-driven dollars.

The provider’s NPI tenure is long enough to suggest an established local presence: the NPI was enumerated on 2006-02-02 (~20 years ago), which supports interpretation of current volume and rank data as the output of an entrenched facility rather than a newly opened operation. Analysts should treat observed high ED volumes as likely reflective of sustained service patterns rather than transient start-up effects.

Where the data show typical versus exceptional utilization, labels in the dataset guide interpretation: several high-revenue codes are marked “typical, unremarkable volume” (for example 99285, 74177, 99213, 97214, 87637 in their respective entries), which suggests the provider’s share for those codes is within expected state peer ranges even when they contribute materially to revenue. Conversely, codes explicitly labeled “notably above typical state volume” (99284 and 99282) identify targeted areas where the hospital outperforms most in-state peers and where payer or competitor attention may be most warranted.

Medicaid: Complete Services Breakdown

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

224 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	22,000	$100	$2.2M
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.	7,760	$160	$1.3M
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.	19,590	$60	$1.3M
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.	2,330	$380	$888.9K
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…	19,150	$40	$670.3K
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…	12,760	$40	$535.9K
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)…	5,730	$80	$481.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	19,800	$20	$396.1K
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.	8,030	$40	$313.3K
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.	2,330	$130	$310.2K

Showing 1–10 of 224

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

St Joseph Hospital Of Nashua Nh — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

224 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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.	11	60	1,820	$150	$756.5K
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.	5	80	2,220	$120	$745.6K
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.	5	70	2,540	$110	$733.8K
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.	13	50	1,150	$230	$480.4K
G0378	Hospital observation service, per hour	10	20	1,390	$190	$406.3K
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)…	2	10	450	$120	$403.9K
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.	15	50	1,250	$90	$224K
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…	36	420	480	$50	$223.9K
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.	2	50	2,010	$80	$209.6K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11	50	1,240	$40	$195.1K

Showing 1–10 of 224

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sivaram Yamajala	MA	Internal Medicine Physician	$54.1K	$636K
Brian Murphy	PA	Urology Physician	$249.2K	$0
Richard Hayes	MA	Cardiovascular Disease Physician	$240K	$0
Janelle Williams	NH	Medical Physician Assistant	$238.9K	$0
Guha Venkatraman	NJ	Neurology Physician	$230.9K	$0
Sarah Atkinson	OR	Neurology Physician	$181.5K	$0
Neelantha De Silva	FL	Neurology Physician	$143K	$0
Cherif Abdelmalek	NH	Medical Oncology Physician	$126.2K	$0
William Barrow	FL	Neurology Physician	$124.4K	$0
Joshua Mendelson	FL	Clinical Neurophysiology Physician	$121.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Council Of Nashua Nh, Inc.	NH	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$75.7M
Harbor Homes, Inc.	NH	Federally Qualified Health Center (FQHC)	$0	$23.4M
Southern New Hampshire Medical Center	NH	General Acute Care Hospital	$0	$22.3M
Life Coping Inc.	NH	Case Management Agency	$0	$17.6M
King Healthcare Group LLC	NH	Substance Use Disorder Rehabilitation Clinic/Center	$0	$15.1M
Plus Co. Inc.	NH	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.8M
Alpha Home Care Solutions, Inc	NH	Home Health Agency	$0	$8.4M
Lamprey Health Care Inc	NH	Federally Qualified Health Center (FQHC)	$0	$8.1M
Nashua Center For The Multiply Handicapped, Inc.	NH	In Home Supportive Care Agency	$0	$6.8M
Foundation Medical Partners Inc	NH	Internal Medicine Physician	$0	$5.8M

St Joseph Hospital Of Nashua Nh — 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