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

Why is the Medicaid comparison limited to Louisiana 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. Louisiana (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 Francis Medical Group LLC (NPI 1134405087)

St Francis Medical Group LLC is a internal medicine physician provider located in Monroe, Louisiana. This profile covers 0 Medicare and 131 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	St Francis Medical Group LLC
Address	312 Grammont St Ste 411
City	Monroe
State	LA
ZIP	71201
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 24, 2011

Payer Source	Total Paid
Medicaid	$8.4M
Medicare	$0

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

131 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	46,580	$40	$1.8M
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…	47,700	$30	$1.3M
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…	61,840	$20	$1.2M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	1,360	$550	$742.6K
99204	The provider sees a new 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 provider…	5,540	$60	$354.6K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,660	$80	$303.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	10,470	$30	$303.6K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	6,730	$40	$269.2K
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…	2,840	$60	$181.6K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	5,120	$40	$179.1K

Showing 1–10 of 131

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Louisiana Distribution

St Francis Medical Group LLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Louisiana

Full comparison — all codes billed, vs. Louisiana median

131 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	20	50	590	$110	$249.9K
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…	57	2,890	980	$40	$246.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	5	80	120	$610	$246.8K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	51	190	660	$70	$234.9K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	19	150	340	$120	$204.6K
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…	107	3,230	1,120	$30	$204.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	21	110	560	$50	$173.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40	470	560	$40	$157.3K
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…	81	360	780	$50	$141.5K
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…	85	420	740	$50	$137.3K

Showing 1–10 of 131

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gregory Sampognaro	LA	Interventional Cardiology Physician	$799.6K	$0
Thomas Smith	LA	Interventional Cardiology Physician	$409K	$0
Nidhi Batra	LA	Retina Specialist (Ophthalmology) Physician	$357.7K	$10.4K
Amin Elmalah	LA	Internal Medicine Physician	$351.7K	$0
James Onyirimba	MS	Nephrology Physician	$284.3K	$0
Jeffrey Hilbun	LA	Interventional Cardiology Physician	$273.3K	$0
Nauman Khalid	LA	Interventional Cardiology Physician	$239.4K	$0
Michael Sampognaro	LA	Internal Medicine Physician	$203.9K	$0
Tommy Banks	LA	Family Medicine Physician	$186.6K	$0
Rolf Morstead	LA	Physical Medicine & Rehabilitation Physician	$117.6K	$50.7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Care Solutions, Inc.	LA	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$49.8M
Affinity Health Group, LLC	LA	Family Medicine Physician	$0	$34.6M
Ascent Health, Inc	LA	Community/Behavioral Health Agency	$0	$31.4M
Cognitive Development Center Personal Care Services	LA	Nursing Care Agency	$0	$27.8M
St Francis Medical Center, Inc	LA	General Acute Care Hospital	$0	$27.2M
Enrich Personal Care Services, LLC.	LA	Preferred Provider Organization	$0	$26.7M
Southern Center For Children And Families, Inc.	LA	Community/Behavioral Health Agency	$0	$24.5M
Afnb Home Care LLC	LA	In Home Supportive Care Agency	$0	$19.3M
D & D Community Connections	LA	Preferred Provider Organization	$0	$19.2M
Hearts Desire LLC	LA	In Home Supportive Care Agency	$0	$17.3M

St Francis Medical Group LLC — Billing Profile & Reimbursement Data

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St Francis Medical Group LLC — 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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